Straight from the Heart

What is angina?
It’s a recurring pain or discomfort in the chest that occurs when a part of the heart does not receive adequate blood.

‘‘It is a common symptom of coronary heart disease, occurring when vessels carrying blood to the heart get clogged with cholesterol,” says Dr Nishith Chandra, senior consultant of cardiology at Escorts, New Delhi. ‘‘When 70 per cent of the artery is blocked, we call it angina,’’ he adds.

What does it feel like?
Angina is a pressing or diffused pain in the centre of the chest. Sometimes it travels to the shoulders, arms, neck, jaws, or back as a crushing or heavy or gripping pain. It is relieved within a few minutes of rest or consumption of angina medicine. It may be accompanied by breathlessness.

Why does it occur?
Blood vessels narrow down with age. But cigarettes accelerate the process. High cholesterol levels, high BP, obesity and diabetes increase the risk. Emotional or physical stress, extreme cold or heat, heavy meals and alcohol are also triggers.

Is a heart attack the next stop?
Angina pain does NOT mean the heart muscle is suffering irreversible, permanent damage, which is what a heart attack is. But, says Dr Chandra, ‘‘when untreated, the risk of heart attack increases with every episode of pain.’’ Diagnostic tests may be needed to exclude angina or establish the severity of the underlying coronary disease.

But is all chest pain indicative of angina?
Nope. For example, if the pain lasts for less than 30 seconds or if it goes away with a deep breath, after drinking a glass of water, or by changing position, it is almost certainly NOT angina.

How is angina treated?
Through lifestyle changes. ‘‘Controlling physical activity, adopting good eating habits, moderating alcohol consumption and not smoking are some of the basic precautions,’’ says Dr Chandra.

The most commonly prescribed drug is nitroglycerin, which relieves pain by dilating blood vessels. Bypass surgery or angioplasty is the extreme solution.