Understanding Angina

💡 What is Angina?

Angina is chest pain or discomfort that happens when your heart muscle doesn't get enough oxygen-rich blood. It's usually a symptom of coronary heart disease (CHD), where the arteries supplying your heart become narrowed.

Angina isn't a heart attack, but it is a warning sign that you're at increased risk of one. The good news is that angina can usually be well controlled with medication and lifestyle changes.

What does angina feel like?

• Chest pain — often described as tightness, heaviness, squeezing, or pressure
• Pain spreading — to the left arm, neck, jaw, or back
• Breathlessness
• Feeling sick or sweaty

Symptoms are usually triggered by activity, stress, or cold weather, and typically ease within a few minutes with rest or GTN spray.

⚖️ Stable vs Unstable Angina

It's important to know the difference — unstable angina is a medical emergency.

	Stable Angina	Unstable Angina
Pattern	Predictable — you know what triggers it	Unpredictable — happens at rest or with less activity than usual
Duration	Usually less than 5 minutes	Lasts longer, often more than 15 minutes
Relief	Eases with rest or GTN spray	Doesn't fully respond to GTN
Action	Manage with regular medications	Call 999 immediately

⚡ Common Angina Triggers

Knowing your triggers can help you manage your angina better:

💨 Using Your GTN Spray

GTN (glyceryl trinitrate) spray or tablets quickly relax your blood vessels, improving blood flow to your heart and relieving angina symptoms.

Important GTN tips:

• Carry it always — keep it with you at all times
• Use it before activities — you can use GTN before doing something you know triggers angina
• Check the expiry date — GTN loses effectiveness over time
• Side effects — headache, flushing, and dizziness are common and usually mild
• Don't use with Viagra/Cialis — dangerous blood pressure drop

💊 How is Angina Treated?

Medications

• GTN spray — for quick relief during an attack
• Beta-blockers (e.g., bisoprolol) — slow heart rate, reduce oxygen demand
• Calcium channel blockers (e.g., amlodipine) — relax blood vessels
• Long-acting nitrates (e.g., isosorbide mononitrate) — prevent attacks
• Aspirin — reduces blood clot risk
• Statins — lower cholesterol and stabilise plaques

Procedures (if medications aren't enough)

• Angioplasty & stent — opens narrowed artery with a balloon and mesh tube
• Bypass surgery (CABG) — creates new routes around blocked arteries

Lifestyle changes

• Stop smoking (biggest single change you can make)
• Regular gentle exercise as advised by your doctor
• Heart-healthy diet (Mediterranean style)
• Maintain a healthy weight
• Manage stress
• Limit alcohol

❓ Questions to Ask Your GP