What Does Angina Feel Like?
What Does Angina Feel Like? Causes, Symptoms & Treatment | Alcohol:- Angina classically comes on with exercise, such as walking uphill or rushing.
There are other typical features such as constriction or tightness in the chest and that the symptom can be relieved by rest.
Some patients don’t have the typical symptom and their symptoms may occur in the shoulders or the arms of the jaw or the teeth.
So diagnosing angina or heart pain can be difficult. Some people feel it like indigestion. And that’s a really common situation.
But when walking, they describe a feeling of indigestion. And of course, to the patient, they don’t naturally think immediately of the heart.
Well, the first step in trying to establish whether it’s heart-related pain is based upon history as we’ve discussed. And classically, the symptom can come on with the exercise.
If the symptom is classical, then it’s highly likely that the symptom is angina based upon history alone, but in most cases, we’ll require investigations to truly establish whether there’s underlying coronary artery disease.
How Is Heart Related Angina (Chest Pain) Diagnosis
These days we have a fantastic set of non-invasive investigations to initiate the diagnosis of coronary artery disease.
The mainstay in my practice is a CT coronary angiogram. This is a non-invasive test that takes ten minutes to do and involves small x-ray doses and the use of some contrast.
And we can obtain superb images of the coronary arteries in a rapid non-invasive fashion. This is helpful.
This has developed rapidly over the last few years with the latest machines being fantastic at diagnosing coronary disease.
The second form of a non-invasive test which I use is a stress MRI scan, which looks to see if there’s any problem with the blood flow in the heart arteries.
The next step which is my area of expertise is with invasive angiography. That’s the gold standard really for diagnosing coronary artery disease.
This is a procedure performed under local anesthetic as a day case. And in my hands, from the radial artery. And this is the best method to evaluate the true level of coronary artery disease.
What Can Cause Chest Pain? Symptoms
The main risk factors that we know about are quite well-known publicly. Those are of course smoking but also hypertension, raised blood pressure, and importantly high cholesterol.
There are others such as diabetes and carrying extra weight. The main risk factor that is often under looked at and which we do need to focus on is the family history or the genetics of coronary artery disease.
So, I see many patients either to treat symptoms or for screening who’ve got a strong family history of heart attacks or cardiac events under the age of 60. So, genetics is important.
Difference Between Angina And Heart Attack
Angina is classically a stable condition that occurs with exercise. Patients will describe that after walking maybe 400 yards or walking uphill or briskly, they develop discomfort, and then they have to rest.
The important feature of a stable symptom, angina, is that when they rest, the symptom goes within five or ten minutes.
A heart attack can be quite difficult to diagnose, but typically or classically, this occurs at rest.
Sometimes in the middle of the night but lasts longer than five or ten minutes and can make the patient feel generally unwell with breathlessness or exhaustion.
The classic symptom is a well-described tight band across the chest; which can be a life-threatening condition.
Sadly, some people have a heart attack which is much more difficult to diagnose with rather subtle symptoms of mild discomfort at rest.
And even more difficult, some people have a heart attack with no discomfort whatsoever. And that’s quite common in the elderly and diabetic patients.
So those patients who don’t have any discomfort may just feel generally unwell or feel exhausted or have nausea or feel faint. And in elderly diabetic patients, this is a common picture.
And in those circumstances, heart attacks are frequently missed. A heart attack is sadly still a very, very common condition. It’s one of the commonest causes of death in the United Kingdom at this stage.
There are 200,000 heart attacks each year and about 66,000 patients die from a heart attack every year, and maybe 22,000 of those are under the age of 75.
Despite a lot of the progress we’ve got for the treatment of heart attack which involves opening the artery very quickly using balloons and metal tubes called stents, despite all of this, sadly there are still a lot of people who die from heart attacks.
And detecting coronary disease and giving the prevention that will help reduce the incidence of heart attacks is probably one of the most crucial things we do as cardiologists.
How Do You Treat Coronary Artery Disease
There are two main aspects of the treatment of coronary artery disease. The first is the use of medication to reduce the risk of a heart attack.
And that would be aspirin, the use of a tablet called Astatine which lowers cholesterol, and a Beta Blocker tablet which protects the heart.
The next treatment of coronary artery disease is to open up narrowings using a balloon and a metal tube called a stent. That’s a procedure that I perform via the radial artery which is the pulse at the wrist.
From there, passing a tube up to the heart to open up the artery and put in this metal scaffold which helps the blood flow down the heart arteries to relieve all of the symptoms.
That’s the treatment for angina, but also an emergency treatment for patients who are having a heart attack.