What is Angina?

Angina is a symptom which can indicate a problem with the heart. Classical angina is a sensation which can be localised anywhere in the chest or neck, arm or throat and develops at a time when the heart is doing more work - usually climbing hills, undertaking heavy duties or even just when stressed. A hallmark of angina is that the symptom is effort related, and improves after resting. A coronary artery dilator such as GTN or nitrate would also generally relieve the symptom within a few minutes.

Although angina is a symptom that sometimes indicates underlying coronary artery narrowing, it can often also be a symptom associated with high blood pressure, important valvular disease or in some other cardiological conditions, including Syndrome X.

How can angina be diagnosed?

Due to its association with coronary artery disease, and the fact that patients who suffer heart attacks often report recent onset angina, any new symptoms of angina are usually investigated. Indeed 'new angina' is an indication for referral to a rapid access chest pain clinic for assessment.

Typically a patient presenting with angina would be assessed before undergoing an examination and 'resting 12 lead electrocardiogram'. Other investigations such as echocardiogram, exercise test and angiography are also sometimes needed.

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