What is Angina
Angina is the medical term given to chest pain that occurs when the blood flow to our heart's muscles becomes restricted. Whilst angina is often mistaken for a condition itself, it is actually a symptom of coronary heart disease. Whilst angina is not considered life-threatening, it is a warning sign of poor cardiovascular health. It is estimated roughly that 100 million people worldwide currently suffer from angina.1
What causes Angina?
Angina attacks (bouts of chest pain) occur when the coronary arteries become narrowed or blocked. In most cases, this is caused by long-term plaque build-up on the walls of the coronary arteries. When this occurs, the capacity for blood flow through the coronary arteries becomes restricted or completely blocked, meaning the heart receives a reduced supply of oxygen and nutrients. Consequently, the heart's muscles begin to become weaker and damaged, causing us to experience chest pain (angina). Below are some of the largest risk factors for coronary plaque build-up and angina.
- Inactive lifestyle
- Consuming a diet high in saturated fats, sugars, and salts
- Family history of heart disease
- High blood pressure
Types of Angina
The type of angina an individual has can fall into one of four categories. Below are details of the differences between each type of angina.
Chest pain that is most commonly triggered when the patient is performing some form of physical activity. Pain normally subsides once the individual begins to rest.
Chest pain that can occur randomly and does not have an obvious trigger. Pain cannot always be cured by medication and rest.
Chest pain that is caused by a spasm in the coronary arteries, temporarily narrowing them and reducing the space for blood to flow through them.
Chest pain that occurs as a result of a fault in the microvessels responsible for allowing blood to flow towards the heart. A fault can prevent the microvessels from properly opening, therefore restricting blood flow.
Whilst different individuals may suffer slightly different symptoms, the symptoms listed below are considered the most common. If you suffer from any of the following symptoms, ensure to contact your healthcare provider for an appointment immediately.
- Bouts of chest pain
- Feeling of pressure, tightness, or discomfort in the chest
- Feeling Breathlessness
- Feeling nauseous/vomiting
- Feeling fatigued
There is a range of tests designed to help healthcare professionals assess their patient’s risk of having angina. Below are some of the most common methods and tests used by healthcare professionals.
Your doctor/GP will likely begin by asking you a range of questions to assess how likely it is you have angina. If based on your answers your doctor deems it likely you have angina, you will be referred for further tests. Questions will likely revolve around the following:
- Your symptoms
- When do symptoms commonly occur?
- Frequency and severity of symptoms
- Pre-existing conditions
- Family medical history
An ECG is a test that assesses the electrical activity and rhythm of a patient’s heart. The test can be performed when at rest (standard ECG) or when performing exercise (Exercise ECG)
A special type of dye that shows up on x-rays is injected into the bloodstream via a catheter. Once injected, an X-ray image is taken of the cardiovascular system, allowing doctors to identify areas in which blood flow is restricted.
A range of methods can be used to take images of our cardiovascular system. Images allow doctors to look at areas in which blood flow is restricted or has become blocked. Methods of CV imaging include:
- Nuclear cardiac stress test
- Cardiac positron emission tomography (PET)
- Cardiac MRI
Treatment and Management
The treatment prescribed to angina patients is highly dependent on the type and severity of their angina. Those diagnosed with stable angina will most likely be prescribed lifestyle changes and medication, whereas those with unstable angina may require surgical intervention if their condition is considered severe enough. Below are examples of each of the treatment and management options available to angina patients.
- Physical activity
- Healthy and balanced diet
- Stress management and relaxation techniques
- Calcium channel blockers
- ACE inhibitors
Effect of Exercise on Angina
Unfortunately, exercise will not make an individual's angina go away. However, research has found that regular exercise participation can provide a range of health benefits for angina patients.2 Below are some of the numerous benefits of exercise for angina patients.
- Reduced frequency of angina attacks
- Reduced severity of angina attacks
- Improved cardiovascular health and fitness
- Reduced risk of further complications e.g., heart attack and stroke
Best Exercise Regime for Angina Sufferers
According to The British Heart Foundation, aerobic exercises are the most effective for managing angina. Aerobic exercise is any type of exercise that is performed at a low to moderate intensity and can be maintained for a prolonged period of time.3 Examples include walking, jogging, swimming and cycling. Below are a few tips for those looking to start exercising with angina.
- Start gradually, don’t overdo it!
- Take regular breaks
- Aim for 150 minutes a week (split into 20–30-minute chunks)
- Always bring your medication to your sessions
- If possible, have an exercise partner
- Stop immediately if you suffer chest pain during
When to Contact a Doctor vs Call for an Ambulance
If you suffer from any of the aforementioned angina symptoms, ensure to book an appointment with your doctor immediately. If your symptoms are more severe, you may be suffering from a heart attack. If you or someone around you is suffering from any of the following symptoms, ring 999/911 immediately.
- Severe chest pain
- Chest pain lasts longer than 5 minutes
- Pain beings to spread to other areas e.g. arms and neck
Whilst exercise cannot cure an individual’s angina, it can go a long way in managing the condition and preventing future complications like heart attacks and strokes from occurring. If you have been diagnosed with angina, reach out to your local GP to see which exercises are safe for you. If you suffer from any of the previously mentioned angina symptoms, but are yet to be diagnosed, ensure to book an appointment with your healthcare provider immediately.
- Kenneally E. Use heart to act now on angina [Internet]. Global Heart Hub. 2021 [cited 2022 Aug 4]. Available from: https://globalhearthub.org/use-heart-to-act-now-on-angina/
- Winchester DE, Pepine CJ. Angina treatments and prevention of cardiac events: an appraisal of the evidence. Eur Heart J Suppl [Internet]. 2015 Dec [cited 2022 Aug 4];17(Suppl G):G10–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700909/
- Medicine AC of S. Acsm’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins; 2013. 481 p.
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