Angina Pectoris is a term for chest pain caused by the heart not getting enough oxygen. This lack of oxygen is also called myocardial ischaemia. Although the arteries supplying the heart may provide enough blood (and therefore oxygen) for daily activities, this may not be possible at high-demand times such as during exercise (even just walking), stress, or extreme temperatures, when the heart beats faster and the body requires more oxygen. The symptoms may disappear when, for example, exercise is stopped. If you suffer from angina you are at increased risk of experiencing a heart attack (acute myocardial infarction or AMI) and should see a doctor right away. There are three main types of angina:
- Stable angina is characterised by predictable periods of discomfort that occur during exercise or periods of stress. This pain may be relieved with rest and/or a drug called glyceryl trinitrate (GTN)
- Unstable angina is characterised by sudden and unexpected onset of pain, usually during periods of rest. The pain may be more severe than with typical angina. People with unstable angina are at particularly increased risk for experiencing myocardial infarction (MI), severe cardiac arrhythmia (irregular heartbeat), and cardiac arrest (when the heart stops beating). Unstable angina is an acute emergency and should be treated immediately.
- Variant angina (Prinzmetal’s angina) almost always occurs during periods of rest – usually at night. The cause is a spasm of a coronary artery.
A doctor can identify which type of angina a patient may have based on information obtained from your medical history, and a range of investigations such as electrocardiograms (ECG) and exercise tolerance testing (ETT).
Treatment may include the use of a variety of medications to reduce the frequency and severity of attacks, e.g. beta blockers, nitrates and anticoagulants such as aspirin. Surgical procedures, such as angioplasty or coronary artery bypass grafting (CABG) may be required in some cases.