Angina

Angina is chest pain caused by the heart muscle not receiving enough oxygen. It is a symptom of coronary heart disease.Cause. When the coronary arteries are partly blocked by atheromas, enough blood may still reach the heart muscle at rest. But during exercise, stress or cold weather, the heart beats faster and harder, and the heart muscle needs more oxygen. The narrowed arteries cannot deliver enough.Short of oxygen, the cardiac muscle cells respire anaerobically for a time, producing lactate. This, together with the lack of oxygen, causes pain. The pain is usually felt as a tight, heavy or crushing feeling in the chest, and it may spread to the left arm, neck or jaw. People may also feel breathless.Relief. Angina pain usually eases after a few minutes of rest, because the heart's demand for oxygen falls back to a level the narrowed arteries can supply. Unlike a heart attack, angina does not cause permanent damage to the heart muscle, because the blood supply is only reduced, not cut off.Treatment. A spray or tablet of glyceryl trinitrate (GTN) relieves an attack by dilating blood vessels, which increases blood flow to the heart muscle and reduces the work the heart has to do. Other drugs slow the heart or lower blood pressure, and narrowed arteries can be widened with stents.Angina is an important warning sign. It shows that the coronary arteries are narrowed and the person has a higher risk of a heart attack.