Understanding Angina: A critical warning sign of heart disease

Angina, often mistaken for simple discomfort, is a serious health condition that serves as a vital early indicator of heart disease. As the heart's arteries become blocked or restricted, this type of chest pain emerges, signalling an increased risk of heart attack. Despite its temporary nature, angina should never be overlooked, as timely medical intervention can be the difference between life and death. This article explores the causes, types, and risk factors of angina, as well as the crucial moments when consulting a cardiologist becomes essential.

What is Angina pain?

Angina, a type of chest pain, serves as an early warning system for heart disease. It occurs when the heart's vessels become clogged, increasing the risk of a heart attack. Characterised by recurring episodes of dull pain or discomfort, angina can radiate to the jaw, throat, back, left arm, or shoulders. Although the pain often subsides with rest or medication, it's crucial to address it promptly, as 33% of angina patients do not survive their first heart attack.

What causes Angina?

Angina occurs when heart vessels become clogged, reducing blood flow and oxygen supply to the heart. This condition is often characterised by a dull pain or discomfort in the centre of the chest, which may radiate to the jaw, throat, back, left arm, or shoulders. The pain typically subsides with rest or nitrate medication, but its temporary nature can lead to complacency.

However, angina should not be underestimated. A staggering 33% of patients with angina do not survive their first heart attack. The condition is caused by the gradual build-up of cholesterol deposits and fats in the arteries, blocking oxygen-rich blood from reaching the heart. This typically occurs when arteries are blocked by 70-80%, with a heart attack happening when the blockage reaches 100%.

A study revealed that 8% of patients with blocked arteries experienced daily or weekly episodes of angina, while 25% had monthly episodes. Alarmingly, 67% did not exhibit chest pain. Therefore, any abnormal pain should be treated as a red flag, and consulting a healthcare professional is essential to determine the cause and receive proper treatment.

When should one go to a cardiologist?

Don't dismiss mild or intermittent chest pain—get it evaluated. It may seem like heartburn or a pulled muscle, but ignoring it can lead to severe consequences. In some cases, symptoms may not appear until blood flow is critically blocked, resulting in a simultaneous heart attack and angina. Seek medical attention to determine the cause and prevent potential disasters. Your doctor will make a decision about your blockage based on your angiography and may recommend placing a stent. They will also likely prescribe statins to control cholesterol, clopidogrel to prevent clotting, and beta-blockers to slow the heart rate, relieve heart stress, and lower blood pressure.

Types of Angina pain

If you experience chest pain or heaviness during physical activities like walking or climbing stairs, it may be a sign of stable angina. This condition, characterised by temporary discomfort that subsides with rest or medication, can be a precursor to heart disease. Don't ignore these symptoms; seek medical attention to address underlying heart health issues.

Unstable angina is characterised by severe, unexpected chest pain that persists despite rest or medication, and may even occur at rest. In younger individuals, angina may manifest as coronary artery spasms, causing intense pain that responds to medication. However, this signals a heightened risk of heart attack or life-threatening irregular heart rhythms, necessitating immediate medical attention.

What are risk factors?

These are the same as those of a heart attack, namely high blood pressure, diabetes, high cholesterol, triglycerides, smoking, lack of physical activity, and obesity.