Patient Information > Angina

Angina

Angina is a heavy, crushing pain or a tight feeling in the centre of your chest behind your breastbone (sternum) or on the left side of the front of your chest. The pain can spread out along one or both of your arms, more often the left arm. You may also feel pain in your throat, jaw, stomach and, more rarely, between your shoulder blades. These symptoms usually disappear after 10 to 15 minutes. Angina is the symptom of an underlying disease called coronary artery disease (CAD).

You may find that your angina is brought on by physical activity or emotional stress. Physical activity in cold weather or after eating may bring on an angina attack more easily. If you suffer from angina you will notice that the attacks are usually caused by particular activities or situations so you may be able to avoid those situations that you know may bring on an attack.

If you think you are suffering from angina for the first time, you should see a doctor. If you have been diagnosed with angina, you may have medication to take when you feel an attack coming on. Your doctor will have given you instructions on how to take your medication.

If you feel an angina attack coming on, you should stop what you are doing and wait for the pain to pass. If the pain lasts for longer than usual, or for longer than 15 minutes, you should dial 000.

Angina is a symptom of diseased blood vessels (coronary arteries) in the heart, which in medical terms is known as atherosclerosis of the coronary arteries. Atherosclerosis is the build-up of fatty material in the blood vessels, and these fatty deposits are called atheroma.

The coronary arteries supply the heart with blood, which carries nutrients and oxygen. When there is a build-up of fatty material in these blood vessels, this is known as coronary artery disease (CAD).

The heart is a muscle and it pumps blood around your body. The heart relies on the coronary arteries to supply the oxygen and nutrients it needs. If your coronary arteries have a build-up of fatty deposits (which is like limescale clogging up your shower), your blood vessels become narrower so less blood can flow through them. When you start to exercise or get stressed, your heart starts to beat faster. As your heart beats faster it needs more oxygen, but because your blood vessels are narrowed, the amount of oxygen-rich blood reaching your heart is reduced. When your heart needs oxygen but is not receiving enough, you start to feel the crushing pain known as angina. It is important to relax as soon as you feel an attack starting.

Stable angina

If the fatty deposits are attached to the blood-vessel wall, you will have symptoms of stable angina. This means that you will probably feel pain at the same level of stress or exercise.

Unstable angina

As your angina develops, it is possible for the fatty deposits (also known as plaques) in the blood vessels to break down and form a blood clot (known as a thrombosis). You may be in pain even when you are resting, and your medication may not ease the pain. Unstable angina is a very severe and dangerous form of angina, and you will need hospital treatment for pain relief and specialist treatment as the risk of heart attack is very high.

How long will I have angina for?

It is quite common for your angina to stay the same for years without getting worse. In some patients, angina symptoms may disappear for long periods, while in others the attacks may become more frequent and more painful.

The underlying cause of your angina cannot be reversed, but effective medication can keep you pain-free. The aim of medical treatment is to reduce your symptoms and prevent you from having a heart attack. If your angina becomes severe or if your medication no longer relieves your symptoms, you may need a small operation (see surgical treatments). However, your GP or a doctor at the hospital will decide if this is necessary and answer all your questions.