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Angina

What is angina?

Angina (also known as angina pectoris) is the name given to pain in the chest that comes from the heart when it is short of oxygen. The heart is a large muscle that pumps blood about every second, and if it cannot get enough oxygen from its own blood supply (the coronary arteries) it will develop a 'cramping' pain rather like the cramp in the calves of the leg. The main cause of angina is a narrowing of the coronary arteries by a fat-like deposit called atheroma. It is a common problem and affects nearly half a million Australians.

What are the symptoms?

Angina is typically a dull, heavy discomfort or pain in the centre of the chest. It has been described as 'pressure', 'tightness', 'heaviness' and 'like indigestion'. The pain can spread to the neck (throat), the jaw, the back or the arms (usually the left arm).

Additional symptoms that may accompany angina are shortness of breath, sweating, nausea and tiredness.

What brings on angina?

Angina characteristically appears during physical activity and fades away when the exertion stops. It can also be brought on by highly emotional situations (e.g. anger, fright, excitement), cold weather or after a heavy meal. People who smoke heavily or are overweight are more likely to suffer from angina.

What are the risk factors for angina?

• Smoking
• high blood pressure
• a high blood cholesterol level
• obesity
• diabetes
• There is also a tendency for it to run in families.

Is angina dangerous?

Angina is a symptom that serves as a warning that the muscle of the heart is not getting enough blood and there is a risk of a heart attack. Angina does not usually cause any damage to the heart.

What tests can be done?

Sometimes it is difficult to be sure that chest pain is true angina, and so an ECG (electrocardiogram) may help the diagnosis. The ECG can be performed while you are Iying down (the resting ECG) or when stressed, such as cycling on a stationary bike (the stress ECG). If surgery is being considered, the state of the coronary arteries can be determined by special X-rays. All patients should be tested for high blood cholesterol.

What is the treatment?

Self-help

• If you smoke, stop.
• If you are overweight, go on a sensible diet.
• If you are inactive, take on an activity such as walking for 20 minutes a day.
• If you are tense and stressed, cultivate a more relaxed attitude to life.

Medical help

There are many tablets that can help, including Anginine, which dissolves under the tongue. It is usual to take half an aspirin tablet each day. Your doctor will advise you about these tablets and other medication.

What are the warning signs of angina?

• Patients usually cope well with their angina by using a disciplined approach to life.
• However, there are some warning signs that mean that the problem is worse than usual and your doctor should be notified:
• angina that lasts longer than 10 minutes
• angina pain that is more severe than normal
• Anginine tablets (up to 3) not easing the pain
• angina becoming more frequent for no apparent reason
• pain coming on at rest for the first time
• new symptoms, such as sweatiness and breathlessness
  

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia