Angina pectoris

Overview

Angina (angina pectoris) is the main symptom of coronary heart disease. It is caused by the narrowing of the coronary arteries as a result of the build-up of fatty deposits and hardening of the artery walls (arteriosclerosis). This means that the heart muscle no longer receives enough oxygen, and causes pain and a feeling of pressure behind the sternum. A healthy lifestyle can have a preventive effect.

Symptoms

• Sudden attacks of pain and feeling of pressure behind the sternum (angina pectoris = “chest tightness”)
• Pain can radiate to the left arm, lower jaw, upper abdomen or back
• Anxiety, fear, nausea

Stable angina

• Symptoms always appear under the same circumstances (reproducible)
• Pain improves rapidly on resting
• Symptoms don't appear to worsen
• Not immediately threatening, but requires examination and treatment

Unstable angina

• Pain attacks last longer than for stable angina
• Now appear at the slightest exertion or while at rest
• Typical heart attack symptoms: skipped heartbeats, shortness of breath, feeling that you are going to die, nausea and “cold sweat”
• Great risk of a heart attack

Causes and treatment

Cause

Heart muscle doesn’t receive enough oxygen due to the narrowing of the coronary arteries and reduced flow of blood.

• Accounts for up to 95% of coronary sclerosis cases (blood flow restricted by the build-up of plaque in the coronary arteries)
• Less often: coronary artery spasms, heart defect or heart valve defect

Direct triggers of angina attacks

• Physical exertion
• Agitation, annoyance, fear
• Cold (swimming in cold water)
• Bloated stomach

Risk factors (for cardiovascular diseases)

• Can't be influenced
  • First-degree relatives suffered heart attack/CHD before the age of 55 (men) or 65 (women)
  • Advancing age
  • Gender: men more often than women
• Can be influenced
  • High blood pressure
  • High blood fat levels (LDL cholesterol, triglycerides)
  • Obesity
  • Diabetes
  • Metabolic syndrome
  • Lack of exercise, smoking and persistent stress

Further treatment by your doctor / in hospital

Possible tests

• ECG (electrocardiogram)
• Blood test (in particular heart enzymes)
• Contrast radiography (coronary angiography using a heart catheter)

Possible therapies

• Nitroglycerine preparations and other medication
• Balloon dilation of arteries, stent
• Bypass operation

What can I do myself?

• First attack
  • Remain calm
  • If pain doesn't disappear rapidly on resting: call emergency services
  • While waiting, make sure the patient has fresh air, elevate the upper body and put the patient in as relaxed a position as possible
• Angina pectoris has been diagnosed: avoid strenuous physical activity and other triggers
• Take nitroglycerine (for acute cases)
  • Should always be at hand for immediate administration
  • Pain should improve within five minutes
  • If pain lasts longer than ten minutes: call emergency services

Remove or reduce risk factors

• Low-fat, vitamin-rich and high-fibre diet
• Sufficient exercise
• Normal weight (maintain or aim for)
• Stop smoking
• Regular relaxation
• Take medication (e.g. for diabetes and high blood pressure) conscientiously

Get a personal Preventive Care Recommendation now.

When to see a doctor?

• First attack of chest tightness and chest pain
• Worsening of symptoms
• Symptoms don't improve within ten minutes of taking medication
• Typical heart attack symptoms
  • Skipped heartbeats, shortness of breath, feeling that you are going to die
  • Nausea, “cold sweat”
  • Dizziness or loss of consciousness

Further information

Schweizerische Herzstiftung (Swiss Heart Foundation)
www.swissheart.ch

Synonyms

angina pectoris, angina