Angina
In the Western world, heart attacks remain one of the most common causes of sudden and premature death. Particularly at risk are middle-aged males who smoke, are overweight and take little, if any, regular exercise.
Although some heart attacks come out of the blue, and are the first sign that there is a problem with the heart, many of those affected will have had the warning sign known as angina.
Angina is a pain, or feeling of discomfort in the chest. It is usually felt in the centre of the chest, but may spread to the neck or arms (especially the left one) and is sometimes felt in the shoulders or back. It usually comes on during physical exertion and stops when the exertion ceases. It is often described as a feeling of 'tightness' or 'pressure' and can range in severity from a mild ache to severe pain.
Angina is due to the heart's muscle not getting enough oxygen. During exercise the heart's workload increases dramatically, requiring the muscle to work much harder. To do this the muscle needs oxygen, which is carried in the blood flowing through the coronary arteries. When these arteries are narrowed (usually due to fatty deposits in their walls) they cannot deliver enough oxygen, and angina occurs.
Most people with angina need to have special investigations to see if their coronary arteries are badly narrowed. If this is the case surgery may be needed to bypass the blocked arteries. Several other procedures are also available to 'unblock' affected arteries.
Not everyone needs surgery and there are other ways to treat angina. These include tablets taken on a daily basis; patches stuck to the skin; and drugs, known as nitrates, that are used to relieve a sudden attack. Nitrates are sometimes given in the form of a tablet placed under the tongue when angina is felt. They also come in an aerosol spray, which is squirted under the tongue.
Nitrates are very useful in relieving the pain of angina, but can cause temporary side effects. These include headache, flushing and dizziness or a light-headed feeling. If you are using these medications it is important to sit or even lie down.
If angina is not relieved quickly, the affected person should get to hospital as quickly as possible in case they have had a heart attack.
Last Reviewed: 22 August 2005
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