Angina
What is It?
Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease (narrowing of the heart’s arteries). At rest, this restricted blood supply may not cause symptoms, but during exertion the heart demands more oxygen and the restriction presents as chest pain or tightness. Angina is very common and serves as a warning sign of underlying coronary artery disease. Stable angina is predictable and triggered by exertion, while unstable angina occurs at rest or unpredictably and requires urgent medical attention
What are the symptoms?
Angina typically presents as chest tightness, pressure, squeezing, or burning, often occurring during physical exertion, stress, cold weather, or after heavy meals. The discomfort may radiate to the arms, neck, jaw, shoulders or back, and may be accompanied by shortness of breath, sweating, nausea or fatigue. Symptoms usually last a few minutes and are relieved by rest or nitroglycerin. Experiencing these symptoms at rest may indicate unstable angina or a heart attack and requires immediate medical attention – call 000.
What are the causes?
At One Heart Centre our cardiologists screen for all causes of angina. Causes include:
- Coronary artery disease (most common): Plaque buildup narrows the coronary arteries.
- Coronary artery spasm (Prinzmetal’s angina): Sudden tightening of the arteries, sometimes at rest.
- Microvascular disease: Damage to the small blood vessels of the heart.
- Risk factors include high blood pressure, high cholesterol, diabetes, smoking, obesity, physical inactivity and family history.
How is it investigated?
Although the diagnosis of angina can be strongly suggested by symptoms, specific tests are needed to confirm it. Usually an ECG is performed at baseline, followed by either an exercise stress test, stress echocardiogram, CT coronary angiogram (CTCA), or cardiac MRI. An invasive coronary angiogram may be needed in selected cases. Your One Heart Centre cardiologist will discuss which test is best for you.
What are the treatments?
At One Heart Centre our cardiologists have post-fellowship training in managing angina and will provide a personalised treatment plan for your angina. Treatment options include:
- Medical therapy: Medications to relieve symptoms and prevent progression, including nitrates, beta-blockers, calcium channel blockers, aspirin and statins.
- Risk factor modification: Lifestyle changes including smoking cessation, regular exercise, healthy diet, and management of blood pressure and cholesterol.
- Coronary angioplasty and stenting: A minimally invasive procedure to open narrowed arteries.
- Coronary artery bypass graft (CABG) surgery: For patients with complex or severe disease.