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illnesses and conditions

Angina

IT may start as an uncomfortable heavy'' feeling in the chest. But the pain of angina can be severe and frightening as the tightness or dull discomfort in the centre of the chest spreads to the neck, arms, back or even stomach.

The cause is simple - not enough blood is getting to the heart. And this condition, arteriosclerosis, is said to kill more people than all other diseases put together.

But by looking after your health and taking care of yourself, the chances of becoming one of those grim statistics can be lessened.

What happens is that the blood vessels that supply the heart become narrowed by a gradual build-up of fatty material within their walls, and can't provide enough blood and oxygen for the heart's needs.

In time the artery may become so narrow, that it can't deliver enough blood to the heart when its demands are high, such as during physical activity or emotional upset, when it has to work harder. So it can be brought on for example by exercise, after a heavy meal, during a bout of anger or anxiety and it is worse in the cold, but can also happen at rest.

The heaviness or tightness is caused by the heart muscle becoming short of oxygen.

Rest will often relieve the pain and drugs such as nitroglycerine which temporarily widen the coronary arteries are used to treat it.

And with proper treatment and adopting a lifestyle that will reduce the risk of further heart trouble, you can relieve the symptoms and prevent it getting worse.

You are particularly likely to develop angina if: you are a cigarette smoker you have high blood pressure you have a high cholesterol level you have little physical activity you are diabetic But there are several things you can do to prevent your angina from getting worse, or progressing to the point where you have a heart attack or need surgery.

Smoking - A major cause of coronary heart disease, especially among younger people. The risk of dying from heart disease is halved within two years of quitting smoking. So if you smoke, give up.

High blood pressure - If you have it, it is essential to control it. Sometimes this can be achieved by losing weight, increasing physical activity and cutting down on alcohol and salt. But most patients also need to take tablets to lower it.

Cholesterol - Needs to be watched. The aim is to have a cholesterol level of under five and a healthy diet will help, which means cutting down on fats in general, especially saturated fats, which are found mostly in meat and dairy products. And beware of 'hidden fats' in cakes and biscuits too. Many people with angina actually need drugs to achieve the low levels of blood cholesterol, and you should seek more information on this from your GP.

Diet - Eat more fruit and vegetables. Those who do are less prone to heart disease. Five or more portions a day are recommended. Oily fish, such as herring, kippers, sardines, salmon, pilchards, two or three times a week are beneficial Control your weight. Keep close to the recommended weight for your height. This will keep your blood pressure down, and reduce the amount of work your heart has to do.

Be more physically active - this can keep your heart healthy, and help keep your weight down. And most people feel better when they feel fit. But it should be within the limits of your angina, or breathlessness. If you have angina, you need to find out what you can easily manage, then gradually increase the amount of activity you do.

Stress - If you have angina, you have to learn how to relax. Try and avoid situations at work and at home that make you stressed. Some people find yoga and other relaxation techniques help.

To sum up:

Don't smoke, drink in moderation, take regular exercise, watch your weight and eat a healthy diet that is high in fibre, low in fat and includes at least five portions of fruit and veg a day.

There is a difference between angina and a heart attack. A heart attack happens when a narrowed coronary artery becomes blocked by a blood clot.

The chest pain that comes with a heart attack is usually more severe than angina. But a change in the pattern of angina could be a sign that a heart attack is on the way, so it needs urgent investigation and treatment. Don't hesitate to seek medical help.

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