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Angina: A Useful Guide

• Written by Josh

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Angina is a common medical condition which affects older people. As the UK's population ages, more and more people are being diagnosed. Currently, it's estimated that around 2 million people in the UK have angina: 14% of men and 8% of women. As you can tell from these statistics, angina is more common in men than women. It is also more common in those over the age of 55.

You may have seen our in-depth guide to the medical conditions which affect older people. Today's article focuses on angina, as we look at the symptoms, treatments and possible causes of the condition.

What is Angina?

The British Heart Foundation (BHF) defines angina as being a pain or discomfort in your chest, usually caused by coronary heart disease. This pain is due to a reduction or restriction of blood flow to the heart, usually because the arteries have become narrowed or hardened. The medical name for this process is atherosclerosis. Your arteries harden and narrow due to a build-up of substances known as plaques. This restricts the blood flow to the heart and therefore triggers the symptoms of angina.

Chest pain from angina could feel like a squeezing pressure or heaviness. It usually begins in the chest but can also spread to your abdomen, shoulders, back, neck, jaw, or arms. Unlike other cardiovascular problems, angina pain tends not to change with movement, deep breaths, or coughing. In most cases, the pain usually stops after a few minutes. This is known as an angina attack.

Types of Angina

There are two different types of angina to look out for:

  1. Stable Angina - This is when an attack has obvious triggers such as exercising or stress. Stable angina can be improved with medication and enough rest.
  2. Unstable Angina - This is when an attack is unpredictable, occurring with no obvious triggers. Angina pain can occurs even when you are resting. Medication might not make it stop. With unstable angina, an attack can also make you feel nauseous, dizzy, short of breath, or sweaty.

Although stable angina is not considered life-threatening, it should be a serious warning sign. Developing angina means you could be at risk of a life-threatening heart attack or a stroke.

In contrast, unstable angina can be a medical emergency, so it requires treatment quickly. It is a sign that the function of your heart has suddenly and rapidly deteriorated.

What to Do During an Angina Attack

During an angina attack, you will feel a heaviness or tightness feeling in your chest. This feeling may also spread to your arms, neck, jaw, back or stomach. The strength of this feeling varies between different people. Some may also experience breathlessness during an attack.

It is very important to understand whether you're having an angina attack, or if something much more serious is taking place. If you experience the symptoms of an angina attack but you have never been diagnosed with angina, you should call 999 immediately.  This is because it can be hard to tell the difference between angina pain and the symptoms of a heart attack. If aspirin is easily available and you're not allergic to it, take one tablet while you are waiting for the ambulance to arrive.

After receiving a diagnosis, if you have an attack you should take your prescribed medicine. If the pain does not go away after 5 minutes, take a second dose of medication. Then, if your chest pain doesn't go away 5 minutes after your second dose of medication, you should call 999 right away.

Treatment for Angina

There are a few main medical treatments for angina. Most people can manage their condition with medication, while surgery might be helpful in severe cases.

Glyceryl Trinitrate

Angina treatment aims to reduce the number of attacks you have, as well as reducing the intensity of the symptoms. One of the most common types of medication for angina patients is glyceryl trinitrate.

These tablets belong to a group of medication known as nitrates. They work by relaxing and widening the blood vessels that supply blood to the heart, which may have become narrower due to coronary heart disease. One dose of this medication should help to ease the pain during an attack within two to three minutes.

Side effects can include headaches and dizziness. In order to keep these effects minimal, you should avoid drinking any alcohol whilst taking your tablets. These tablets usually expire after about eight weeks, at which point you will need a new supply. Therefore, you may prefer to use glyceryl trinitrate spray, because it lasts for a longer period of time.

Preventing Attacks

Other medicines can help prevent attacks from happening at all. This kind of treatment will usually involve you taking at least one form of medication every day for the rest of your life. Your doctor or cardiologist will try one type of medication first to see if this helps before applying a second if this does not work.

These medicines include:

  • Beta-Blockers. These make the heart beat slower with less force. This means that the heart requires less blood and oxygen after exercise. Side effects include tiredness, cold hands and feet, diarrhoea and sickness.
  • Calcium Channel Blockers. These relax the muscles which make up the wall of the arteries, increasing blood supply to the heart. Side effects include headaches, dizziness, skin rashes and tiredness, although these should pass after a few days. You should never drink grapefruit juice while using these tablets, as this can cause a drop in blood pressure.
  • Long-Acting Nitrates. Similar to glyceryl trinitrate, these tablets are designed for the long-term prevention of angina symptoms. Side effects include headaches and a flushed face.

Surgery 

If medication has no effect on your symptoms, you might need surgery to help manage your condition. There are two types of surgery for angina:

  1. Coronary Artery Bypass Graft. Surgeons take a section of blood vessel from another part of the body and use it to re-route the flow of blood past a blocked or narrow section.
  2. Percutaneous Coronary Intervention. This involves the widening of a narrow artery using a tiny tube known as a stent.

If medication and surgery do not improve your symptoms, the use of psychological or behavioural treatments may be the next option. One example would be cognitive behavioural therapy, which helps to develop your skills to cope with your condition, manage your pain and improve your symptoms.

Credit - British Heart Foundation

How to Prevent Angina

In order to reduce the risk of angina, you should ensure that you have a healthy lifestyle. You might need to make changes to your diet, for example. Try to eat plenty of fruit and vegetables, which are full of useful vitamins, minerals and fibre. You should also include wholegrain rice, bread and pasta in your diet, in order to reduce your risk.

In addition, try to avoid eating too many high-fat foods, such as butter, hard cheese, meat pies and sausages. Instead, you should try eating small amounts of unsaturated fats, such as avocados and oily fish, as they increase the level of good cholesterol in your body. Your salt intake should also be less than 6g per day.

Alongside the healthy diet, you should stop smoking. Smoking has a direct link to the narrowing of your arteries, and it also raises your blood pressure. This automatically raises the risk of both heart attacks and strokes.

Drinking too much alcohol has a similar affect on your blood pressure. With this in mind, you need to keep to the guidelines which states that you should not drink more than 14 units a week. Alcohol is also high in calories, so you'll gain weight if you drink regularly, which can further increase your blood pressure.

With a healthy diet should come an active lifestyle. Taking part in regular exercise helps to keep your heart and blood vessels in a good condition. It also has countless other benefits, from better mood and mental health to helping prevent or delay dementia. The healthier you live your life, the better shape your heart will be in.

Living with Angina

Most people with angina are able to live normally and have a good quality of life. Those with the condition should make the lifestyle changes we've suggested above in order to keep control of their symptoms.

Your doctor will be on hand to advise you on what you should and should not be doing. If you have angina, it's crucial to know your limits, especially when exercising. It's all about balancing the amount of exercise with the severity of your condition. Physical activity may trigger the symptoms of an angina attack. On the other hand, the more you exercise, the less likely it is you'll have an attack.

People with angina should generally avoid high intensity activities like football and squash. Instead, experts recommend low-impact activities such as walking, swimming and cycling.

Staying safe at home

personal alarm can help protect people who suffer from medical conditions like angina. If one of our alarm users feels unwell, or suffers a fall, they can press their pendant button and we will arrange help immediately.

For more information on purchasing one of our life-saving personal alarms, please speak to one of our friendly advisors on 0800 999 0400. Alternatively, complete our contact us form and we will get back to you as soon as possible.

VAT Exemption

People with angina are automatically eligible for VAT Exemption when they order a personal alarm system from Lifeline24. This means that you won't have to pay any VAT on your new Lifeline alarm. For information on the other conditions which qualify you for VAT exemption, see our handy guide here.

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