Angina

What is Angina?

Angina, or angina pectoris, is the crushing, squeezing sensation of pressure on the chest caused by an inadequate oxygen supply (ischaemia) to the heart muscle tissue. This is most commonly a result of cardiovascular conditions that lead to a compromised blood supply. Angina can be classified as stable, where the chest pain is experienced upon exertion or exercise and is absent at rest, or unstable where angina is present at rest and also becomes progressively more severe.

While stable angina isn’t immediately life-threatening it is potentially symptomatic of a range of cardiovascular issues for which a cardiologist should be consulted. Unstable angina on the other hand is very much a life-threatening condition and should be treated as a clinical emergency due to the massively increased risk of heart attack or stroke associated with it.

What causes Angina?

Atherosclerosis is by far the most common cause of angina. The accumulation of fatty plaque within the wall of a coronary artery can impair the oxygen supply to the cardiac muscle and some estimates state that 75% blockage is required before an individual actually experiences the associated angina.

There are a number of risk factors that are implicated with angina and any underling coronary heart disease, many of which are modifiable. These include hypertension, a sedentary lifestyle, diabetes, kidney disease, smoking, age, family history and a diet high in fat and cholesterol.

What are the symptoms of Angina?

Due to the nature of how your nerves are distributed across your body, pain caused by angina isn’t necessarily exclusive to the chest and can be felt in the left arm, back, neck and jaw. The sensation of pressure can lead to restricted breathing, nausea and dizziness depending on the severity of the condition.

How is Angina treated?

Extremely acute cases of angina are treated with glyceryl trinitrate which helps by rapidly dilating blood vessels and ameliorating the insufficient oxygen supply to the cardiac muscle. Afterwards preventative measures are taken which can include the use of beta-blockers to reduce the speed and intensity of heart beats, calcium channel blockers which relax the muscle that makes up arterial walls and long-acting nitrates (glyceryl trinitrate being a fast-acting, short-term example). Many people with angina will also present with associated cardiovascular issues and will take statins, ACE inhibitors and aspirin in order to reduce the risk of heart attacks or stroke.

The most serious cases may require surgical intervention such as stenting or a coronary artery bypass graft in order to improve blood flow.