Angina

There are two main types of angina:

• Stable angina – This is more common, and attacks will have a trigger such as stress or exercise. These attacks stop within a few minutes of resting.
• Unstable angina – This is more serious, and attacks are more unpredictable, as they may not have a trigger. They can continue despite resting.

Some people develop unstable angina after having stable angina.

The usual symptom of angina is central chest pain. Some people have other symptoms:

• Chest feels tight, dull or heavy or sharp, stabbing pains
• Pain spreads to arm, neck, jaw or back
• Pain in your tummy like indigestion
• Shortness of breath
• Feeling sick (nausea)
• Feeling very tired pain can be triggered by physical exertion or stress and may stop within a few minutes of resting. Other triggers include eating, cold weather and emotional upset.

Angina is usually caused by the arteries (blood vessels) supplying blood to the heart muscles becoming narrowed by a build-up of fatty substances. This is called atherosclerosis. This reduces the blood supply to the heart muscle.

Things that can increase your risk of atherosclerosis include:

• Unhealthy diet including too much alcohol
• Lack of exercise
• Smoking
• High blood pressure
• High blood cholesterol
• Being overweight or obese
• Increasing age
• A family history of atherosclerosis or heart problems

If you haven’t been diagnosed:

• Stop what you’re doing immediately and rest.
• Make an urgent appointment to see your GP if the symptoms go away within a few minutes.
• Call 999 for an ambulance if the symptoms don’t stop within a few minutes – as this could be a heart attack.
• If aspirin is available and you’re not allergic to it, chew a 300mg tablet whilst waiting for an ambulance. This can help if you are having a heart attack.

If you have already been diagnosed:

• Stop what you’re doing immediately and rest.
• Take medicine prescribed for you (glyceryl trinitrate, or GTN, spray or tablets).
• Take another dose after 5 minutes if the first dose doesn’t help. Call 999 for an ambulance if you still have symptoms 5 minutes after taking the second dose.

Treatment can assist in stopping angina attacks and reduce the risk of problems like heart attacks. Your GP may be able to tell whether you have angina from the symptoms you describe. Your GP may want to carry out a health check or arrange some tests like blood tests, an ECG, or a heart scan.

Most people with angina will need to take several medicines, usually for the rest of their lives.

Medications include those that treat the attacks when they occur as well as medication to reduce the risk of further attacks and the risk of heart attacks and strokes.

Surgery such as coronary angioplasty or heart bypass surgery may be recommended if the medicines don’t help.

To read more on the treatments available click here.

If you have angina you will be at risk of more serious problems such as heart attacks and strokes.

To decrease your risk of problems like these, you should:

• Eat a healthy balanced diet
• Cut down on alcohol
• Stop smoking if you smoke lose weight if you’re overweight

It is very important to stay active if you have angina. You may worry that exercising could trigger your symptoms or cause a heart attack, but the risk is low if you:

• Build up your activity level gradually and take regular breaks.
• Keep your GTN spray or tablets with you.
• If needed, use the spray or take a tablet before starting exercise.

You should speak to your GP if you are unsure whether it’s safe for you to exercise.

Read here about easy, low impact exercises you can try out.

If you work, you can normally continue to do so. Be sure you keep your GTN medicine with you just in case.

If your job requires heavy lifting or involves manual labour, speak to your employer about changes you can make to decrease the risk of an attack.

This may mean changing your duties or cutting back on how much heavy work you do.

Some people who have angina worry that sex will prompt an attack, but the risk of this occurring is low.

You should keep your GTN spray or tablets to hand in case you need them.

There is some helpful information about ‘sex when you have a heart or circulatory condition’ on the British Heart Foundation website.

You should consult with your GP whether it is safe for you to drive.

You can usually continue to drive if you have been diagnosed with stable angina. You will need to stop driving if your attacks happen while resting, driving, or are caused by an emotion. You can start driving again when your symptoms are well controlled.

Whatever type of licence you hold you should always let your car insurance company know about your heart condition and any changes in your medical condition, including any treatment that you’ve had. If you don’t, your car insurance may not be valid.

You will not need to inform the DVLA about your angina if you only carry a car or motorcycle license. You must tell the DVLA if you have a bus, coach or lorry licence.

Click here to read the Government rules regarding angina and driving.

Please click on the links below for more useful information on angina:

• British Heart Foundation
• Patient.info: Angina

All about angina

All about angina | https://www.bhf.org.uk

British Heart Foundation | published on 29 September 2017

Symptoms and how to treat angina

Symptoms and how to treat angina | https://www.sja.org.uk/

St John Ambulance | published on 15 June 2015