What is angina?

Angina pectoris derives from Latin and translates as 'tight chest'. It feels like an oppressive, heavy, crushing pain or a constricting feeling in the centre of the chest behind the breast bone (sternum) or on the left side of the front of the chest. The pain can radiate out to either one or both arms, more often the left. It can be experienced in the throat, jaw, the stomach and, more rarely, between the shoulder blades.

Angina is often brought on by:

• - physical exercise
• - psychological stress
• - extreme cold
• - a heavy meal.
  

Once these trigger factors stop, the pain generally abates quickly, usually within 2 to 10 minutes.

In most cases, the cause of angina is coronary atherosclerosis (thickening of the arteries supplying blood to the heart). These arteries supply the cardiac muscle with blood and therefore oxygen and nutrients.

Narrow coronary arteries reduce the blood flow to the heart muscle. This is usually noticed at times when the heart muscle needs more blood supply, such as during exercise.

The heart, when it increases its workload, will receive too little oxygen which causes pain in the heart. In severe cases this can also happen when the heart is at rest.

Angina can be aggravated by other illnesses including:

• a sustained fast heartbeat.
• anaemia (thin blood).
• heart valve diseases, such as severe aortic stenosis
• a narrowing of the outflow valve of
  the heart.
• thickening of the heart muscle
• hypertrophy
• which can occur in patients with high blood pressure over several years.
• more rarely, a severe spasm of a coronary artery can occur even when the patient has relatively minor coronary atherosclerosis.

Atherosclerosis affects many people in developed countries. It may start as early as your 20s
and increases with age.

Numerous 'risk factors' are known to be associated with the development of atherosclerosis.

• A family history of atherosclerosis.
• Hypercholesterolaemia - a high content of (LDL) cholesterol in the blood.
• Hypertension (high blood pressure).
• Smoking.
• Being male.
• Type 1 diabetes and Type 2.
• Obesity.
• Stress.
• Lack of regular exercise.

All symptoms typically occur in connection with physical exertion or psychological stress.
They are often worse in cold or windy weather, and sometimes after big meals.

• A squeezing or heavy pressing sensation on the chest.
• A sense of heaviness or numbness in the arm, shoulder, elbow or hand (usually on the left side).
• A constricting sensation in the throat.
• The discomfort can radiate into both arms, jaw, teeth, ears, stomach or between the shoulder blades.
• Increased shortness of breath on exercise.
• More severe unstable angina can be associated with the same symptoms at rest.

Do something to eliminate the risk factors mentioned.

Eat a varied and healthy diet; leafy vegetables, unprocessed cereals, low-fat, high-fibre products. Avoid saturated fats.

Stop smoking. Your doctor or pharmacist will be able to provide advice about stop smoking programmes and smoking cessation products.

Lose weight, if you are overweight.

Exercise more (a half-hour walk each day is much better than nothing at all).

If you suffer from Type 1 diabetes or Type 2, or high blood pressure maintain treatment for these conditions.