At Complete Care Shop, we’re here to help explain the symptoms of angina and the treatment options available so that those living with the condition can be as well-informed and independent as possible. If you’re concerned about any of the angina symptoms you read here, please consult your GP.

What is angina?

Angina is a pain or discomfort that’s felt in the chest area. It’s also often found in the arms, neck, stomach or jaw and occurs when the blood supply to the muscles of the heart is restricted. It’s a symptom of coronary heart disease.

If you would like more detailed information on angina, the British Heart Foundation is an excellent starting point.

What causes angina?

The heart needs oxygen-rich blood to function correctly and blood is supplied to it by two large coronary arteries. Fatty substances in the blood can clog these arteries and make them narrower in a process called atherosclerosis.

This is caused by:

• Smoking
• High blood pressure
• Diets containing high levels of saturated fat and cholesterol
• Type 1 and type 2 diabetes
• Lack of exercise
• Age
• Family history

The narrowing of arteries causes angina symptoms to develop and marks the beginning of coronary heart disease. Some people find that certain factors bring on their symptoms.

These triggers often include:

• Physical activity
• Emotional upset, stress or worry
• Cold weather
• Eating a large meal

What are the different types of angina?

There are two main types of angina which are defined by what triggers symptoms. They are:

• Stable angina - Out of the two types of angina, this is not life-threatening and is less severe, but it is a serious warning sign of a possible future heart attack or stroke. Stable angina is brought on by a specific trigger, like exercise, and often occurs in a regular pattern.
• Unstable angina - This type of angina is dangerous and requires emergency treatment. It usually signifies that a heart attack is very likely to happen. Unstable angina attacks can happen suddenly with no obvious triggers. It’s an unpredictable and more painful type of angina and it’s possible to be given a diagnosis of this type for the first time with no history of angina at all.

As angina is directly linked to the blood flow to your heart, it’s important to take any symptoms seriously. If you’ve been diagnosed with stable angina, you’ll likely know what has caused your symptoms but you must be sure to rest and take your prescribed medicine to prevent further complications to your health.

If your angina has occurred with no obvious triggers then it’s vital you seek emergency treatment quickly as you may be at risk of experiencing a heart attack.

What are the symptoms of angina?

The most common symptom of angina is a feeling of pain or discomfort in your chest that is often described as tight, dull or heavy. The pain can spread from your chest to your left arm, neck, jaw and back. Some people say the pain can feel like indigestion.

Other angina symptoms that might occur in addition to chest pain include:

• Breathlessness
• Dizziness
• Fatigue
• Feeling sick
• Restlessness

If you have already been given an angina diagnosis, you may experience pain or discomfort that you can manage by taking medication. If you have been given a diagnosis of angina and have an attack, but feel that it is different to normal, or if your medication doesn’t work, you could be having a heart attack. Symptoms of angina and symptoms of a heart attack are similar but a heart attack feels more severe. If you have a heart attack you may feel:

• Crushing pain, heaviness or tightness in your chest
• Pain in your arm, neck, throat, jaw, stomach or back
• Light-headed or sick
• Short of breath
• Sweaty

If you experience any of the above symptoms, call 999 immediately and alert someone close by if possible. If you have a family member or friend with angina or any other heart condition, read how to administer first aid in the event of a heart attack at the British Red Cross.

Living with angina

It is possible to live a full and active life if you’re given an angina diagnosis, although it will likely affect your daily routine to some degree. Your personal experience of living with angina will depend upon the type you have and how effective your treatment is. You’ll be advised by your healthcare professional to look at ways in which you can improve your overall health, which could include changing your diet, increasing your exercise levels and, perhaps, stopping smoking.

Read on to discover the effects of living with angina, what angina treatments are available, and why a healthy balanced diet for angina patients is important.

Impact on daily living

Living with angina can be challenging. Depending on the severity of your symptoms, you may find some daily tasks difficult. For example, if exercise is one of your triggers, you may find you have an attack when you overexert yourself. If cold weather triggers your angina, you may find winter challenging. You can manage the effects of angina attacks by taking your medication and resting. This should help you feel better soon and give you the energy to continue your daily tasks.

Angina causes some people to feel worried or stressed, which can have a negative impact on their daily life and overall health. If you’re finding it difficult to manage your concerns, try to talk about them with loved ones, friends or your GP.

If you feel you need some equipment at home to help with daily tasks which are more challenging due to your angina symptoms, Complete Care Shop can help. We have a team of Occupational Therapists (OTs) to advise you on how to use daily living aids in the home to make things easier.

Here are some tasks that some people can find difficult because of the symptoms of angina, and examples of the angina aids that are available to help:

• Feeling breathless and needing to rest when out and about - A 2-in-1 Rollator & Transit Chair gives you support when walking and a convenient place to rest if you experience an angina attack.
• Feeling dizzy when standing and preparing food - A height-adjustable Perching Stool offers a convenient resting place where you can carry out tasks around the home comfortably.
• Finding it difficult to exercise in cold weather - A Pedal Exerciser is a perfect way to practice steady exercise from a seated position at home.

Finding it difficult to stand in the shower for long periods - A Shower Stool could help you shower comfortably.

How is angina treated?

If you have angina, you’re likely to be prescribed a medication called glyceryl trinitrate (GNT). This is delivered either as a spray or a tablet that dissolves under your tongue. This treatment works by relaxing and widening the blood vessels that supply blood to your heart.

You may experience mild side effects as soon as you take it, such as headaches, flushing and dizziness. Many people are able to manage their angina symptoms using this type of treatment for angina.

You may be prescribed alternative medications or advised to use a combination of medications as treatment for angina. These include:

• Beta-blockers
• Calcium channel blockers
• Long-acting nitrates
• Ivabradine
• Nicorandil
• Ranolazine

You may also be prescribed medicines that reduce your risk of a heart attack or stroke, including:

• Statins
• Low-dose aspirin
• ACE inhibitors

If medication does not work for you or stops working, you may be advised to have surgery, which is usually one of the following procedures:

• Percutaneous coronary intervention (PCI)
• Coronary artery bypass graft (CABG)

The NHS has more angina information in regard to treatment.

Diet and exercise after angina diagnosis

Eating a healthy diet is essential to reduce your risk of having a heart attack or stroke. It may also stop your angina from getting any worse.

A balanced diet that includes lots of fruit, vegetables and fibre, with fewer foods that are high in saturated fat, is extremely important if you have heart disease. Reducing your blood cholesterol is also necessary, which you can achieve by limiting the amount of foods you eat that contain saturated fats. These foods cause harmful types of cholesterol which create a build-up of fatty deposits in your arteries.

Saturated fats are found in:

• Dairy – butter, ghee, lard, cream
• Fatty meats
• Cheese – especially hard cheese
• Sweet foods – biscuits, cakes, chocolate
• Some oils – palm oil and coconut oil

Increasing the amount of ‘good fats’ in your diet can actually help lower your cholesterol. These can be found in:

• Nuts and seeds
• Avocados
• Oily fish
• Olive oil, rapeseed oil, vegetable oil, sunflower oil

Reducing your salt intake is also important because this will help lower your blood pressure. Remember that pre-packaged foods such as soups, ready meals, and sandwiches all contain salt at fairly high levels. Reducing your alcohol consumption is also highly recommended if you have angina.

If you need more advice or encouragement to follow a healthier diet for angina, speak to your GP. You may also like to learn more about eating ‘5 a day’ with NHS Live Well.

In terms of exercise, it’s important for everyone in order to lower the risk of developing heart disease and angina. Exercise makes the heart stronger so it can pump more blood through the body. It also reduces the levels of bad cholesterol that can cause fatty build-up in the arteries.

If you have angina, it’s even more important to exercise in order to reduce any further damage to the heart, lower your cholesterol and lower your blood pressure. You should look to undertake an activity which increases your heart rate such as walking, cycling, swimming or jogging.

There are a number of small changes you can make to increase your exercise levels throughout the day. They include:

• Walking to the shops instead of driving
• Taking the stairs instead of the elevator
• Walking the dog
• Doing some gardening
• Playing with your children or grandchildren

Exercising for 30 minutes each day is enough to help reduce your risk of heart attack or stroke. Splitting the 30 minutes into three 10-minute sessions is a great starting point, eventually building up to longer sessions.

Exercise and a healthy diet can help you lose weight too, which helps to reduce the strain on your heart.

Smoking and angina

If you’re a smoker who has been diagnosed with angina, one of the most important things you must do is give up the cigarettes. Smoking damages the lining of your arteries which leads to narrowing, therefore causing angina. Smoking also increases adrenaline and reduces the amount of oxygen in the blood which puts the heart under more pressure to work harder.

It doesn’t matter how long you’ve been smoking; it’s never too late to stop and there is an abundance of help and support available. Speak to your GP or an NHS Stop Smoking advisor who can help you.

Angina and employment

Despite being given a diagnosis of angina, many people continue to work. Some people will choose to change jobs, retrain, or work fewer hours with less stress. If you’re unsure about whether or not you can continue working while living with angina, speak to your GP and cardiologist. You may also wish to discuss your role and tasks with your employer or occupational health adviser who can support you after diagnosis.

Support and resources for people living with angina

There is a lot of support out there for people with angina and heart disease. You should never feel as though you are alone in your angina diagnosis. There is a network of healthcare professionals to offer angina support and a number of communities and charities offering angina help and advice.

• British Heart Foundation - the nations heart charity and the largest independent funder of cardiovascular research.
• Chest, Heart and Stroke Scotland (CHHS) - health charity to improve the quality of life for people in Scotland affected by chest, heart and stroke illness.
• Heart Research Institute UK - institute which conducts research to prevent death and suffering from cardiovascular disease.
• NHS Choices - helps to explain health conditions in more detail.

Angina glossary

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology.

Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of angina as straightforward as possible.

• Antipsychotic drugs - A potentially serious condition where arteries become clogged with fatty substances called plaques, or atheroma.
• Cholesterol - Cholesterol is a fatty substance that is primarily made in the body. Some cholesterol is good for the body, whilst some is bad and causes a build-up of fatty deposits in the arteries (one of the main causes of heart disease). Good cholesterol actually helps decrease the amount of the ‘bad’ cholesterol.
• Coronary heart disease - A condition in which fatty substances build up in the walls of the arteries that run to your heart. This causes them to narrow, which can reduce the supply of oxygen to your heart.
• Coronary artery bypass graft (CABG) - An operation on the heart where a section of blood vessel is taken from another part of the body and used to re-route the flow of blood past a blocked or narrow section of artery.
• Glyceryl trinitrate - Used as a treatment for angina and other heart conditions. Part of a family of medications called nitrates which help relax the blood vessels in the body (causing them to widen) and this reduces the strain on the heart, making it easier for the heart to pump blood around your body.
• Percutaneous coronary intervention (PCI) - A heart operation where a narrowed section of artery is widened using a tiny tube called a stent.