Angina

Angina describes the pain, and sometimes breathlessness or choking feeling, caused by restricted blood flow in the arteries that supply the heart. The word angina comes from the Latin angerer, which means to strangle.

Angina pain

A first attack of angina pain typically starts during exercise such as walking uphill. It may be feel like a heavy weight or a tightening across the upper chest. Angina pain is especially likely to occur when walking after a meal, or in cold, windy weather. Anger or stress tend to makes it worse. The pain can move to the neck, throat or arms - making you feel that you are choking or that both arms are dead weights. The pain doesn't usually last for more than a few minutes and goes fairly quickly after resting. As well as the pain, there may be breathlessness, sweatiness and a sense of fear. Angina affects about one in 50 people and can have different causes. It can often be controlled with a combination of medication and lifestyle changes.

Causes

Most angina is due to disease of the coronary arteries (atherosclerosis) that results when the arteries become furred up with fatty deposits. The diagram above shows the blood supply of the heart, including the coronary arteries. The narrowing of these arteries means the heart muscle cannot receive enough blood (and therefore oxygen and nutrients), especially when extra demands are made on it through exertion. However, other problems may also be the cause of angina. These include:

narrowing of the aortic heart valve
anaemia,
fast, abnormal heart rhythms,
diseases of the heart muscle.

Types of angina

There are three main types of angina:

Stable angina

Stable angina is associated with coronary heart disease, and is brought on by exertion. In this case, the angina pain usually lasts for only a few minutes. After resting, the pain subsides, but it will usually return when the effort begins again.

Unstable angina

With this type of angina, the pain comes on after only a little effort (such as just taking a few steps) or even when the person is resting. It is usually the result of a very severe narrowing (stenosis) in a coronary artery.

Variant angina

This type of angina occurs without warning, usually in women. It is due to spasm of a coronary artery. A doctor may need to make detailed investigations to diagnose this type of angina. During an attack, there can be irregularities in the heart's normal rhythm.

Heart attack

If a coronary artery becomes completely blocked, the section of heart muscle supplied by that artery will die, unless the blockage is relieved quickly. This is a heart attack (myocardial infarction, or MI), and the pain is more severe and prolonged than angina. Someone having a heart attack will also feel sick, breathless and sweaty, and may vomit.

Who gets angina?

Angina occurs more often in older people. When it occurs in younger people (under age 50), it's more common in men than women. You are more prone to angina if you:

smoke,
have a high cholesterol level,
have high blood pressure,
have diabetes,
do little physical activity.

In some cases, angina runs in families, so if close relatives have had angina, you may be at a greater risk of getting it too.

Diagnosis

If you have developed a read more