Angina: Everything you need to know

Angina: Everything you need to know


Angina can be a worrying condition, especially as it shares some signs and symptoms with having a heart attack or stroke.

This makes it important to research facts about angina and familiarise yourself with its causes and treatment.

What is angina ?

In common with other heart conditions, angina is severe pain in your chest (called ischemic chest pain).

The pain is caused by an interruption to the blood flowing to your heart muscles.

The good news is that angina is not life-threatening. It is possible to control it with medication and changes in your lifestyle.

However, angina can be an early warning sign! Having problems with blood flow to your heart could lead to far worse risks, including strokes and heart attacks.

Angina is generally categorised in two ways: stable and unstable.

Stable angina

Is when your pain is triggered by something easy to identify, such as stress or overexertion. The pain eases in minutes once you rest and relax.

Unstable angina

Is the most unpredictable version of this medical condition. Attacks can be sudden and have no clear explanation, and they may not be as easy to control with rest.

Some people have stable angina for a while and then it changes into a more unstable form of the condition.

What causes Angina?

It is a form of ‘coronary heart disease’, which refers to conditions impacting on the functioning of your heart.

Angina is the result of a process called atherosclerosis. This is the medical term for when your arteries become clogged up due to a build-up of fatty substances known as plaques.

  • Fatty foods and an unhealthy diet

The more of these fatty substances there are, the more your arteries will narrow and harden.

Variant angina is when the main artery to your heart (the coronary artery) goes into spasm as a result of this process.

There is also something called microvascular angina. This is when your arteries look normal when tested (no fatty substances can be detected) but they still sometimes interrupt the blood flow.

Having your arteries restricted in this way interferes with the way your heart muscles work, making it difficult for this vital organ to do its job properly! Blood pumped around your body contains oxygen, which is what every part of your body needs to function.

What causes plaques to form in your arteries?

  • A family history of atherosclerosis or heart problems

There is evidence that a family history of conditions like angina increases an individual’s risk of developing it themselves.

  • Smoking
  • Not enough exercise
  • Age

Other ways you increase your risk of angina (and other atherosclerosis medical issues) include eating badly and not exercising enough. Smoking can also contribute.

In a nutshell, your lifestyle is generally believed to be what puts you at most risk from angina, though your chances of developing this condition increase as you get older too.

Angina Symptoms

The main symptom of angina is pain in your chest area.

This pain can take different forms, and its severity depends to some degree on your resistance level. What one person sees as ‘discomfort’ could potentially be severe pain to another.

It pays to be alert to any degree of pain in your chest, as angina could be a dull, heavy feeling or the sensation of tightness across your chest.

Angina pain could also spread to your left arm, and into your neck, jaw and back.

Other angina symptoms include feelings of nausea or finding that you are struggling to breathe.

The triggers for angina symptoms could be stress – or getting very upset – or doing something physically demanding. Angina symptoms can also be more likely if the weather is cold or you eat a large meal too!

How do I know if I have angina?

One of the ways you can tell you have angina is to consider what you were doing before the pain began. As mentioned, often physical exertion or an episode of feeling upset or anxious can trigger an angina attack.

Also, angina pain may well pass in minutes, once you rest.

Other heart conditions may not have these clear triggers and the pain could be constant even when resting.

Clearly, the best way to know if you have angina is to seek help and advice from a medical professional. This should be done as a matter of urgency. They will take a full medical history and ask all the relevant questions. They will also do tests, such as an ECG or heart scan.

If they do reach a diagnosis of angina, they can help you to find the right treatment and suggest ways to self-manage the condition.

It is important to note that if your chest pains do not ease after a few minutes of rest, you must ring 999. You need immediate help as this could be a heart attack or stroke.

Also, seek immediate medical advice if you have a diagnosis for angina and you feel your attacks are becoming more frequent or severe.

Angina Risk Factors

There are a number of factors that can increase your risk of developing Angina or Coronary Artery Disease. If you have already been diagnosed with Angina, the following can also make your symptoms much worse:

  • High blood pressure - Hypertension makes it harder for blood to flow through your arteries and can also cause long term damage to them such as hardening. Angina coupled with a high blood pressure can really reduce the blood flow to the heart. 
  • Lifestyle choices such as tobacco use, lack of exercise, obesity caused by a bad diet, and also stress levels.
  • Diabetes - this is one of the main causes of Coronary Artery Disease which leads to Angina and can also cause high cholesterol levels
  • High Cholesterol Levels - In the right levels, it keeps your body functioning in a healthy and normal way. However, if you have an excessively high level of these lipids, it can lead to serious health conditions such as narrowing of the arteries, heart attacks and strokes.
  • Genetics - A family history of coronary artery disease will put you at a higher risk of developing Angina
  • Old Age - Naturally, men ages 45 are at a reater risk of developing Angina as are women over the age of 55.

Angina treatment and medications

Generally, people with angina will need to take medications to control the condition for the rest of their lives.

This includes medications to achieve three purposes.

The first is to alleviate the symptoms of angina; to make you feel less pain and discomfort.

Another type of medication for angina is preventative such as beta-blockers; it will make it less likely for you to have future attacks (including nitrates). Propranolol  is the most commonly prescribed beta blocker to prevent angina and a number of other heart related conditions.

Thirdly, you could be prescribed medications to prevent your angina from putting you at risk from strokes and heart attacks such as statins that lower high cholesterol levels.

In severe cases of coronary heart disease, surgical intervention is required. This includes coronary angioplasty or heart bypass surgery to free up blood flow when the risk to life is significant.

There are positive lifestyle steps that make your angina medication more effective and that help to avoid attacks or worsening complications.

This includes having a healthy, well-balanced diet. It is also highly recommended that you engage in gentle, low impact exercise. Things like walking and slow swimming can avoid triggering an angina attack but are excellent for improving your circulation, heart strength and general level of fitness.

Diet and exercise can help you to manage your weight too, as being overweight can be a factor in all forms of coronary heart disease.

Stopping smoking and reducing your alcohol intake can also be important when living with angina.

If you have other medical conditions, managing them properly can help avoid angina attacks too. This includes careful control of blood glucose if you have diabetes and getting help if your blood pressure is consistently high.


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