ANGINA

What is it?

Angina is a pain, usually in the chest, due to a lack of blood in the blood vessels that send blood to the heart muscle.

What causes it?

Angina happens when the blood vessels, which supply the heart muscles, are narrowed. This is usually because the vessels have furred up, preventing enough blood from getting through. If you suffer from angina, the more blood the heart muscle needs (such as during exercise or stress, when it beats faster) the more likely you are to get an attack of angina.

Who gets it?

Men are more at risk from angina than women are. In women, the risk goes up after the menopause. You are more likely to get angina if you smoke, are overweight, have high blood pressure, have high cholesterol or suffer from diabetes. If there is a lot of heart disease in your family, you may also be more likely to get angina.

What are the symptoms?

You will probably first notice a pain in the middle of the chest, like a heavy weight or a tight band around the chest. Sometimes, the pain goes up into the neck or down the left arm. You may notice that you feel dizzy, sick or breathless at the same time. The pain may be brought on by exercise (or simply by rushing around), by feeling stressed or by going out into the cold. You should find that if you sit down and rest, the pain will go in a few minutes.

When should I go to my GP?

If you have a pain you think might be angina, you should make an appointment with your GP as soon as possible. The doctor may be able to tell you straight away that the pain is not angina but is caused by a strained muscle in the chest or by indigestion.

What tests will my GP do?

Your GP might want you to have a tracing of your heart called an electrocardiogram (ECG). This doesn't hurt, and involves simply lying down for a few minutes while pads connected to a recording device are attached to your chest. Depending on what else your GP finds, he or she may send you for a blood test or an X-ray of your chest.

What is the short-term treatment?

You will probably be given some tablets or a spray to put under your tongue when you feel the pain. This should make the pain disappear within a few minutes. When you first take the medication, you will probably find it gives you quite a bad headache but this soon wears off if you take it regularly.

Will I need long-term treatment?

If you are getting a lot of angina, or it is happening often enough to be a problem, your GP may suggest you start regular treatment. This could be tablets or a patch, which you stick to your skin. If you also have high blood pressure, you may be given one tablet to help both your blood pressure and your angina. If your cholesterol is also very high, this may need treatment and regular blood tests.

How can I stop it getting worse?

It is extremely important not to smoke if you have angina. Likewise, you should ensure you do not drink too much alcohol. If you are overweight, you should lose weight and should always try to have a healthy diet, with lots of fresh fruit and vegetables and not too much fat or sugary food. If you are diabetic or your cholesterol is high, watching your diet will be especially important. You should take regular exercise (although you will have to build up an exercise programme slowly and not do anything that is too strenuous too soon. Ask your doctor how to go about this.

Will I need regular check-ups?

If you are on long-term treatment, your GP may want to see you every few months to ask how you are and to examine you. He will also advise you to come back if your symptoms get worse or stop being controlled by the tablets you are taking.

Will I have to go to hospital?

Your GP may refer you to hospital if you do not improve with tablets and your angina is bad. Sometimes, if your symptoms are bad, you may need surgery to open up some of the blocked blood vessels or to replace them, You may also need to be admitted to hospital if your angina suddenly gets worse. If you have a particularly bad attack lasting more than half an hour which is not helped by your tablets or spray, go straight to hospital.