top of page
chest-pain.jpg

Angina

Angina is chest pain, chest tightness, or discomfort, that occurs when your heart does not get as much blood and oxygen as it needs.

Angina and heart attack have the same root cause: atherosclerosis.

 

Atherosclerosis is the buildup of fatty substances (plaque) in the heart arteries. If one or more arteries are partly clogged, not enough blood can flow through, and you can feel chest pain or discomfort called angina.

​

The discomfort could be characterised as pressure or a squeezing in your chest, shoulders, arms, neck, jaw or back. It could also manifest itself as indigestion. 

 

It is important to keep in mind that angina is not a disease; rather is a symptom of an underlying heart problem such as coronary heart disease.

What does angina feel like?

 

There are different types of angina and its important to know how they differ from each other. Depending on the type you may have, the symptoms vary:

 

Stable Angina, also known as Angina Pectoris, occurs when your heart muscle does not receive as much blood as it requires, for instance, during a time of physical exertion or emotional stress. This typically occurs when one or more of your heart’s arteries are blocked or narrowed (known as ischemia). 

​

During an episode of stable angina, you may feel:

  • Chest pain, tightness, or heaviness, often relieved with rest

  • Shortness of breath 

  • Fatigue 

  • Profuse sweating

  • Anxiety

  • Dizziness 

  • Nausea 

 

Stable angina typically lasts a short time (5 minutes or less), and may feel like gas or indigestion. It  is relieved by rest or medicine.

angina.jpg

Unstable Angina is characterised by unexpected chest pain, and mostly occurs while resting. It commonly occurs when the heart does not receive sufficient blood flow on account of arteries blockage by fatty buildups (atherosclerosis), even without a physical activity. The fatty buildups tend to rupture, causing injuries in the blood vessel resulting in clots. 

​

The sensations can vary from person to person, but most common symptoms of unstable angina include:

  • Chest pain, tightness, or heaviness at rest (not relieved with rest)

  • Sharp chest pain that may be described as “squeezing” or “crushing”

  • Radiating pain to upper extremities or back

  • Anxiety 

  • Sweating 

  • Shortness of breath

  • Dizziness

Unstable angina should be treated as emergency. 

​

If you experience stable angina, it is possible for it to progress to unstable angina. Be aware of any chest pains you feel differently, particularly when you are resting. Also watch for pains that tend to last longer. 

Variant Angina, also known as Prinzmetal’s angina or angina inversa, is almost always triggered when a person is resting, e.g. at night, and tends to be very painful. 

 

Variant angina is rare (about 2/100 cases) and can be caused by stress, smoking, cocaine use or exposure to cold weather. 

​

The discomfort during an episode of variant angina: 

Is usually very severe 

Can occur during the night while resting 

Is relieved by itself or with medication 

Microvascular Angina may be a symptom of coronary microvascular disease which affects the heart’s smallest coronary artery blood vessels. This type of angina differs from other types as the chest pain typically lasts longer than 10 minutes, and in some cases, may last longer than half hour. 

​

The pain or discomfort:

  • Can be associated with lack of energy, shortness of breath, or sleep disturbance

  • Is often noticed during daily activities and times of emotional stress 

  • Is usually more severe and lasts longer than other types of angina 

angina_cad.jpg
Understand your risk factors

 

If you are at risk of coronary heart disease, you are also at risk for angina since most of the risk factors are the same: 

 

  • Smoking 

  • High cholesterol 

  • Diabetes 

  • High blood pressure 

  • Obesity 

  • Lack of physical exercise 

  • Hereditary 

  • Age 

  • Diet

Diagnosis of Angina

 

Any chest pain you experience must be checked and examined by your healthcare provider. If you do experience a chest pain, your doctor should find out whether its angina; and if it is angina, it is important to determine which type it is. 

 

Your doctor will most likely ask you a series of questions so have a few answers prepared to:

  • How long have you been experiencing this pain? 

  • On a scale of 1 (mild) to 10 (severe), how would you rate the level of discomfort? 

  • Any particular activity that triggered the pain? E.g., a big meal, running, exercising, drinking etc

  • Anything you take to relieve the discomfort?

 

In order to determine the type of angina you may have had, your doctor may recommend any of the following tests and procedures:

 

  • Electrocardiogram (ECG)

  • Stress testing  and Echocardiography

  • Computed Tomography Angiography

  • Coronary Angiography and Cardiac Catheterisation 

  • Chest X-Rays 

Lifestyle Changes

 

Lifestyle choices you make everyday can either slow or speed up the buildup of plaque in your arteries. Here is a list of things you can do to reduce your risks: 

 

  • Maintain a healthy weight and eat nutritious and balanced diet that is low in salt and fat.

  • Quit smoking

  • Dedicate a half hour for exercise, at least 5 times a week 

  • Learn to manage stress better by setting realistic expectations and adopt healthy ways to relax

bottom of page