Angina, aptly termed "a cry for help from the heart", describes the initial cramping pain in the heart when it doesn't receive enough oxygen-carrying blood. Typically a dull pain or discomfort in the centre of the chest brought on by physical exertion, strong emotion, a heavy meal or cold weather, angina usually subsides when the precipitating action or event ceases. The sensation feels different in different people — common descriptions are "chest tightness", "a heavy weight pressing on my chest" and "a hollow feeling". It can spread to the shoulder, upper arm, jaw or throat — and may be accompanied by sweating, nausea, shortness of breath or light-headedness. The importance of recognising Angina is that it is a warning that the coronary arteries are narrowed - and if neglected, this could well progress to a fatal heart attack.
Anginal chest pain of this type almost always indicates that the coronary arteries are blocked. It is more likely to be experienced by smokers, diabetics, those who are overweight or have high blood pressure or cholesterol.
Risk Factors
Anyone with these risk factors for heart disease who experiences angina, must get themselves checked by a doctor. There is no point in attributing chest pain to "muscle sprain" or "wind" or even that popular empiric diagnosis, "Acid reflux." Even doctors may not be sure that a pain emanating from the middle of the chest is Angina, so blood tests and ECGs will be required. Sometimes, a special ECG taken while exercising (Exercise Stress ECG) will be required.
Medications
Many medications can help relieve Angina - Glyceryl Trinitrate (GTN spray or Anginine tablets) are among the commonset prescribed. Other tablets (like calcium channel blockers and long acting Nitrates) can dilate the coronary arteries and improve blood flow to the heart muscle, while Beta-blockers can slow heart rate and reduce its demand for oxygen. A daily dose of aspirin reduces the "clottability" of blood and prevents clot formation in narrowed arteries.
If the arteries to the heart are significantly blocked, some form of surgery — either Angioplasty (to widen narrowed vessels) or Coronary Artery Bypass Grafting (to replace diseased vessels using normal arteries from the arm or chest wall) — can be undertaken.
Prevent Heart Attacks
The best treatment for a heart attack, of course, is to prevent it - so looking after yourself to prevent yourself getting a heart attack, having your blood pressure checked regularly and keeping it under control, and ensuring that you don't allow alcohol to damage your heart are all easy ways of preventing a failure. Treating heart failure today requires both non-medical and medical methods. Staying active with regular exercise "within the limits of your capability" is important to improve circulation — as is taking a suitable salt-free, anaemia-preventing, low fat diet.
As for medicines, what is most important is to regularly take the medications prescribed for you. If some tablets don't agree with you, don't stop taking them- discuss the side effects with your doctor, who can often provide an alternative.
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