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Angina is a symptom of coronary heart disease, and affects about 1.2 million people in the UK. An episode of angina typically starts with chest pain or tightness when you are doing some sort of physical exercise. It may feel like a heavy weight or a tightening across your upper chest. Angina pain is especially likely to occur when walking after a meal. Anger or stress also tends to make it worse.
What causes angina?
Coronary artery spasm
The walls of the arteries are surrounded by muscle fibers. Rapid contraction of these muscle fibers causes a sudden narrowing (spasm) of the arteries. A spasm of the coronary arteries reduces blood to the heart muscle and causes angina. Angina as a result of a coronary artery spasm is called “variant” angina or Prinzmetal angina. Prinzmetal angina typically occurs at rest, usually in the early morning hours. Spasms can occur in normal coronary arteries as well as in those narrowed by arteriosclerosis.
Symptoms and Complications of Angina
Not everyone with ischemia will experience angina. This is referred to as “silent ischemia.” More commonly, however, people will experience chest pain. The pain of angina comes from the heart, but it’s not generally felt exactly over the heart. The most common focus of pain is under the sternum (breastbone), midway between the breasts or pectoral muscles.
Exercise fitness can go a long way in treating angina. Angina can discourage exercise because it’s painful, but this is the wrong response to the problem. Exercise can encourage the growth of new blood vessels to compensate for existing blockages. Some people whose angina didn’t improve with medications and even bypass operations have become pain-free after a sensible exercise program.
