Dr Simon Kennon MB ChB, FRCP, MD Consultant Cardiologist

Angina

If the arteries supplying blood to the heart become narrowed, due to cholesterol build up, the heart muscle does not receive enough blood. This deficiency of blood, and therefore oxygen, causes chest pain.. Typically the pain is like a heaviness, tightness or crushing feeling. This can spread to the neck, shoulder, jaw, arms (typically the left arm) and even the stomach. Shortness of breath, anxiety and nausea are also commonly reported.

Angina is often brought on by physical activity, and can be exacerbated by cold weather, after a meal or with emotional upset. Symptoms usually subside after a few minutes rest.

Management

There are 2 issues to address: firstly to prevent narrowed coronary arteries becoming blocked coronary arteries, these are termed ‘preventative measure’; secondly to treat the symptoms, to prevent chest pain developing. The first is achieved by stopping smoking (if you smoke) andeating a healthy diet. In addition tablets are required to reduce cholesterol (statins), reduce blood pressure (blood pressure lowering tablets) and to thin the blood (aspirin).

Treatment

tablets can sometimes be effective in reducing angina pains either by slowing the heart rate down or be dilating blood vessels. Common types of ‘anti-anginal’ tablets are: beta blockers, calcium channel blockers and nitrates. If arteries are tightly narrowed, however, tablets are often ineffective and then treatment with angioplasty and stents (‘percutaneous coronary intervention’) or a coronary artery bypass operation are required.