Angina

The degree of angina is measured by the amount of work the heart can do before angina pain sets in, and the pain or the breathlessness make you stop to rest. As angina gets worse you have to stop to rest as you walk down the road, or pause to rest on walking up the stairs.

Angina symptoms are usually described as a crushing , heavy or gripping pain in the centre of the chest, but this can radiate into the neck, jaw and arms (especially the left arm). It is similar to muscle cramp during vigorous exercise.

Angina should be diagnosed and treated by your doctor, who will often prescribe GTN (glyceryl trinitrate) tablets or spray to carry round with you as a very quick acting treatment which works in a minute or two to ease the pain. The tablets should be sucked under the tongue to dissolve, and the spray sprayed under the tongue. These are very quickly absorbed in the bloodstream and relax the blood vessels bringing blood to the heart muscles, so that more blood flows bringing more oxygen to reverse the oxygen debt. GTN is very volatile and is rapidly lost from the tablets unless they are stored very carefully, but the sprays minimise this and so are much more convenient.

Angina pain normally wears off within ten minutes, and you should stop and rest, and take a GTN if needed. If the pain lasts longer than this or feels different, then you should suspect that you are having a heart attack and phone 999 straight away.

More than 2 angina attacks a week will require regular drug therapy with a range of different drugs, or in severe cases surgery.

• Give up smoking
• Healthy Eating is important especially low fat, low salt and high fibre
• Exercise regularly but build this up slowly under your doctor's guidance
• Avoid stress and relax
• Control your alcohol consumption
• Control your blood pressure
• Control your cholesterol and homocysteine levels
• Control your insulin levels by dieting and losing weight if necessary to avoid metabolic syndrome and diabetes