Angina is a type of chest discomfort caused by reduced blood flow to the heart muscle. It is usually a symptom of coronary artery disease, where the arteries supplying the heart become narrowed by fatty deposits (atherosclerosis).

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Angina commonly occurs during physical exertion or emotional stress, when the heart requires more oxygen. The symptoms usually settle with rest.

A cardiology assessment can help determine whether chest symptoms are related to angina and whether further investigation is required.

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Symptoms of angina

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Angina is often described as a feeling of tightness, pressure or heaviness in the chest.

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Symptoms may include:

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• chest tightness or pressure
• discomfort spreading to the arm, neck, jaw or back
• symptoms triggered by exertion
• symptoms that improve with rest
• breathlessness associated with chest discomfort

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Not all chest pain is caused by angina. Many people experience chest discomfort due to musculoskeletal problems, acid reflux or anxiety, but it is important to assess the risk of heart disease carefully.

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Causes of angina

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Angina usually occurs when the coronary arteries become narrowed by the gradual build-up of fatty plaques.

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Risk factors include:

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• high blood pressure
• high cholesterol
• smoking
• diabetes
• family history of heart disease
• increasing age

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Identifying and treating these risk factors is an important part of preventing future cardiovascular problems.

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How angina is investigated

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If angina is suspected, a cardiology assessment may include:

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• electrocardiogram (ECG)
• echocardiography (heart ultrasound)
• CT coronary angiography
• cardiac MRI
• exercise testing in selected cases

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These tests help determine whether there is significant coronary artery disease and guide the most appropriate treatment.

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Treatment for angina

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Treatment aims to improve symptoms and reduce the risk of future heart problems.

Management may include:

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• lifestyle changes such as improving diet and exercise
• medications to improve blood flow to the heart
• treatment of risk factors such as cholesterol or blood pressure
• in some cases, coronary stenting or other procedures

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A personalised treatment plan will depend on the underlying cause and the results of investigation.

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When to seek medical advice

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You should consider cardiology assessment if you experience:

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• chest discomfort during exertion
• chest tightness or pressure
• chest pain associated with breathlessness
• chest symptoms that are worsening over time
• a strong family history of heart disease

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Consultation

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Private cardiology consultations with Dr Thomas Heseltine are available at Spire Murrayfield Hospital Wirral.

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Appointments include a detailed assessment of symptoms and cardiovascular risk, with advice regarding appropriate investigations if required.