Introduction

Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and narrowed.

The pain and discomfort of angina feels like a dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back.

The pain is usually triggered by physical activity or stress and typically only lasts for a few minutes. This is often referred to as an angina attack.

A second dose can be taken after five minutes if the first dose doesn't have any effect. If there's no improvement five minutes after the second dose, call 999 and ask for an ambulance.

Types of angina

The two main types of angina are stable angina and unstable angina.

• stable angina where angina attacks are brought on by an obvious trigger (such as exercise) and improve with medication and rest
• unstable angina where angina attacks are more unpredictable, occurring with no obvious trigger and continuing despite resting

Stable angina isn't life-threatening on its own. However, it's a serious warning sign that you're at increased risk of developing a life-threatening Myocardial infarction or stroke .

Some people develop unstable angina after previously having stable angina, while others experience unstable angina with no history of having angina before.

Unstable angina should be regarded as a medical emergency, because it's a sign that the function of your heart has suddenly and rapidly deteriorated, increasing your risk of having a heart attack or stroke.

This can restrict the blood supply to the heart and trigger the symptoms of angina.

Advanced age, smoking, obesity andeating a diet high in saturated fats all increase your risk of developing atherosclerosis.

A number of medications can be used to try to achieve this. Some of these are only taken when needed, while othersare taken every day.

Surgery to widen or bypass the narrowed arteries may be recommended if the symptoms don't respond to medication.

Complications

A major concern for people with angina is that their atherosclerosis will continue to get worse. This can lead to the blood supply to their heart becoming blocked, which could trigger a heart attack. Similarly, a blockage of the blood supply to thebrain could trigger a stroke.

Each year it's estimated that 1 in every 100 people with stable angina will have a fatal heart attack or stroke, and as many as 1 in 40 people willhave a non-fatal heart attack or stroke.

You can considerably reduce your risk of developing these complications by making lifestyle changes. For example, if you're obese and you smoke, you can significantly reduce your risk by stopping smoking and maintaining a healthy weight .

This figure rises to 1 in every 7 men and 1 in every 12 women who are over 65 years of age.

Angina is more common in men than women.