Angina

What is angina?

Angina is a temporary pain or tightness that starts in the middle of the chest and may then spread to the back, neck, upper jaw, and arms (usually the left arm). The pain is usually heavy rather than sharp or piercing.
Most often, angina comes on suddenly in response to exercise and lasts only a short time. Other things that may trigger angina include eating a large meal, getting anxious, angry or very excited, and walking outside when it is cold or windy. It may also occur at rest, at night or early in the morning and is often accompanied by breathlessness.

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What causes angina?

Like other muscles, the heart needs more oxygen when it exercises. Coronary arteries are blood vessels that supply oxygen and vital nutrients to the heart. In people with angina, these vessels are narrowed and cannot supply the oxygen required fast enough. Angina is caused by an imbalance between the amount of oxygen supplied and the amount of oxygen needed by the heart. The pain is due to the heart muscle becoming short of oxygen.

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Who gets angina?

In the UK, about 1 in 50 people have angina but in males aged between 40 and 64 this rises to 1 in 10.
Angina is more common in people from the Indian sub-continent and those with diabetes.
Before the menopause, women are less likely to develop angina than men but, after that, the likelihood is similar. HRT offers some protection against angina for postmenopausal women.

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What treatments are available for angina?

In most cases, angina subsides with rest. If an attack occurs, stop whatever you are doing and rest until it passes.
Your doctor may have given you tablets or a spray to use under your tongue when you get the pain. These should settle the pain within a few minutes. If the pain does not settle, you can take another tablet or use some more spray. If the pain still does not settle seek medical attention urgently.
Your doctor may also have put you on tablets that you have to take regularly, one or more times every day. These are designed to help limit the increase in the amount of oxygen that your heart needs when you exercise.

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What can you do to prevent angina?

There are also measures that you can take yourself to help treat your angina (see below).
If you smoke, stop. Smoking increases the heart's need for oxygen, which can aggravate angina. If you are overweight, lose weight gradually by eating less and exercising more. Unless your doctor says so, do not stop exercising altogether; your heart can be strengthened by a sensible exercise programme. Your doctor may also recommend that you practice relaxation techniques and try to avoid stressful situations.
If you need more information about angina, ask your doctor or practice nurse.

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Help yourself

• Stop smoking.
• Attain your ideal body weight.
• Keep alcohol intake below 21 units per week if female and 28 units per week if male (1 unit = '/2 pint beer or cider; 1 glass wine; 1 measure spirits).
• Eat a sensible low-fat, high-fibre diet.
• Do not add salt to your food at the table.
• Take regular gentle exercise. Gradually build up the amount of exercise so that the blood supply to the heart muscle increases.
• Avoid stress. Change your lifestyle, workload and leisure time. If you can not avoid stress try learning to relax more to compensate.
• Take all medicines exactly as directed by your doctor and do not share them with anyone else.
• If your doctor has asked to see you regularly, do not miss your appointments.

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Further information

This factsheet supported by Astra

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