Chest pains – Angina pectoris

We should certainly be grateful that some of our health complaints can be linked to lifestyle instead of just being down to chance.

As a result, you can be the master of your own god fortune when it comes to your health issues. Particularly with cardiovascular diseases, there are plenty of risk factors that you can control with the right knowledge.

Because the art of life is of course to live with yourself as well as is possible – especially if you have genes or a lifestyle that is not consistent with your desire to avoid illness.

Caregiver talking with happy man in the wheelchair in a nursing house
This goes for all of us: People who are physically inactive are at twice the risk of developing coronary heart disease compared with people who are physically active – and this is the case both for men and women.

Chest pains – Angina pectoris
Angina pectoris is a condition in which the heart has a reduced supply of oxygen. It is characterised by attacks of chest pain.

The heart muscle is a strong and important muscle that requires a continuous supply of blood and oxygen from its small veins. If some of these veins are unable to supply sufficient blood, usually due to calcification, this reduces the heart’s supply of oxygen.

In people with angina pectoris, these attacks can occur periodically, and this causes chest pain that can last for up to 15 minutes.

We make a distinction between stable and unstable angina pectoris. With stable angina pectoris, the chest pains occur during activity and then subside. With unstable angina pectoris, the chest pains can occur independently of level of activity, even at rest.

Risk factors are heredity, smoking, overweight, diabetes, high blood pressure and high cholesterol. Age is another important risk factor, and we see an increased frequency of the condition in men over 40 years, and in women over 50 years.

Where angina pectoris is suspected, it is important to see a doctor for an investigation, as the condition predisposes for hereditary heart disease, such as myocardial infarction.

Symptoms of angina pectoris
Oppressive or choking chest pains lasting up to 15 minutes are classic symptoms.

Typical symptoms of angina pectoris are discomfort or pain located behind the sternum that is triggered by physical exertion and which goes away again within 2-15 minutes of rest.

The chest pains themselves are often described as oppressive and choking, and some people experience pains radiating out to the neck, jaw or left shoulder/arm.

Women more often than men can present with other symptoms with a variable pain threshold, pains beneath the breasts, palpitations or sharp, stabbing pains that do not always resemble the most classic symptoms.

Older people and patients with diabetes often have symptoms such as laboured breathing on exertion, weakness and sweating.

The attacks are more easily provoked by exertion after a meal and when it is cold outside.

Treating and preventing angina pectoris
A healthy lifestyle and medication are essential for both the treatment and prevention of angina pectoris. Surgery may also be appropriate.

The aim of treatment is to stop the further development of calcification of the veins, and to stabilise the condition.

Giving up smoking, a healthy diet low in unhealthy (saturated) fat and moderate physical activity are extremely important elements of self-treatment for angina pectoris.

Everyone should also have basic medicinal treatment. Among other things, access is required to nitroglycerin, which is available both in the form of tablets that are placed beneath the tongue, and as a spray. The doctor will tell you how to use this in case of an attack.

The doctor will also ensure that you have the best treatment aimed at additional factors, such as treating high blood pressure, diabetes or high cholesterol.

Surgery will be appropriate for some people. One method is called PCI. This is a fast and effective method that does not require the patient to be anaesthetised.

It entails access to the cardiac veins via other veins in the arm or the thigh, in order to open up the cardiac vein that is blocked.

Another surgical method is known as bypass surgery. This is a major heart operation that requires full anaesthesia, and which involves replacing the blocked vein with another healthy vein.

Investigation and diagnosis
Funny nurse woman listening heart isolated on white background
In most cases a diagnosis can be given based on a classic medical history combined with a stress ECG.

It is primarily the classic medical history that gives the doctor the diagnosis. A stress ECG can be performed as an additional tool.

This is a test in which the heart’s activity is observed during physical exertion (cycling on an exercise bike). Heart specialists then interpret the ECG, which shows how the heart functions under stress.

If you benefit from nitroglycerin spray or tablets during attacks, this will further confirm the diagnosis.

Prognosis for angina pectoris
Angina pectoris predisposes for myocardial infarction and heart failure, but with the correct treatment the prognosis is good.

The prognosis depends on how severe the condition is, but a healthy lifestyle and optimal medicinal treatment are usually effective against angina pectoris.

The most important thing you can do yourself is to give up smoking. With effective treatment, both the short term and long term prognoses are good.

With severe illness or where the treatment is not effective, the main complications are myocardial infarction and heart failure.

Facts about angina pectoris:

  • Angina pectoris produces oppressive or choking chest pains.
  • The pains usually pass in about 15 minutes.
  • The pains become worse on exertion and subside with rest.
  • Nitroglycerin will make the pains subside almost immediately.
  • Chest pain, or angina pectoris, is caused by calcification of the veins that carry oxygen to the heart.
  • With the correct medication and a healthier lifestyle, it will be possible to reduce the severity of angina pectoris.

Retired woman with her walking stick