Dr Gill: Coping With… Angina

Advice from our Woman’s Weekly doctor

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Coping with... ANGINA

This chest pain is caused by poor blood flow to the heart muscle

Angina is the warning that a heart attack may later occur. It is usually central, heavy chest pain that may radiate to your neck, left arm, jaw or back. It’s triggered by physical activity or mental stress but usually stops when you rest. You may feel sick, dizzy or breathless, although a few older people may not have much pain.

It is similar to cramp – the heart muscle isn’t getting enough oxygen because the blood vessels that supply it are narrowed, which causes pain, especially when the heart is trying to work harder.

Diagnosis

If you get chest pain that goes when you rest, you must see a doctor urgently. They will examine you, take a detailed medical history and start with an electrocardiogram (ECG) and blood tests.

‘Stable angina’ is where attacks have a trigger but stop within minutes of resting, whereas ‘unstable angina’ is more serious and less predictable. There may be no obvious trigger and it may continue when you’re resting. If it doesn’t completely stop on resting, you must call 999, as you may be having a heart attack (myocardial infarction), where part of the heart muscle is not getting any blood at all and is dying.

At this point, it helps to take an aspirin tablet to thin the blood and help it flow as you wait.

Treatment

Initial treatment for stable angina is with medication to open up the heart’s blood vessels. This includes glyceryl trinitrate (GTN) tablets or sprays, or other longer-acting daily medications such as beta-blockers or calcium channel blockers.