Angina pectoris: What is it exactly?

Angina pectoris, or simply angina, is commonly known as chest pain. Angina is one of the most common symptoms of coronary artery disease (heart disease) and is sometimes difficult to distinguish from other types of chest pain, such as discomfort from indigestion.

“Angina (angina pectoris) is a type of chest pain typically described as a squeezing sensation, pressure, heaviness or tightness in the chest,” says Dr Fam Jiang Ming, Associate Consultant, Department of Cardiology, National Heart Centre Singapore (NHCS), a member of the SingHealth group.

He adds, “If the pain can be felt in the shoulders, arms, neck, or back, and is accompanied by sweating, shortness of breath and nausea, you should seek emergency help immediately.”

What causes the chest pain in angina?

Angina (angina pectoris) is caused by reduced blood flow to the heart muscle. It is most often the result of coronary artery disease, where fatty deposits called plaques limit the supply of oxygen-rich blood going to your heart.

During times when oxygen demand is low, such as when you’re at rest, your heart may be able to get by on the reduced amount of blood flow. However, when there’s an increase in the demand for oxygen like during exercise, angina may set in.

How is angina treated?

Treatment of angina (angina pectoris) varies according to the severity of the condition. In most cases where patients suffer from mild angina, a combination of lifestyle changes and medication can help control symptoms.

Lifestyle changes often include eating a healthy diet, lowering cholesterol levels, regular exercise, quitting smoking, as well as controlling diabetes and high blood pressure. Medicine used to treat angina work either by increasing the amount of oxygen delivered to the heart or reducing the heart’s need for oxygen.

4 common prescribed medicines for treating angina pectoris (chest pain):

1. Nitrates

Nitrates can prevent angina attacks and also relieve symptoms of angina. They work by relaxing blood vessels to the heart, thus increasing blood and oxygen supply.

Examples of nitrates are isosorbide dinitrate (tablets) and glyceryl trinitrate, also called GTN (sublingual tablets or transdermal patch).

Potential side effects of nitrates:

  • Flushing (redness of the skin)
  • Dizziness, fainting spells, rapid heartbeats
  • Headaches
  • Reddening, itching or burning sensation (where the GTN patch was applied)

These side effects tend to be temporary. A painkiller or paracetamol can be taken to relieve the headaches. Contact your doctor if symptoms persist.

Read on for more common medicines for angina pectoris.

Ref: R14