Angina is a heart condition chiefly characterised by episodes of chest pain or tightness.  It occurs when too much strain is put on the heart e.g. during periods of increased physical activity, or sometimes, emotional excitement in patients in whom the arteries are ‘furred up’.  The heart becomes short of oxygen – resulting in sharp pains across the chest.  Some patients have stable angina which means that they know both what will bring on an attack and how to manage it.

Unstable angina is much more serious than stable angina.   Although the symptoms are similar, unstable angina occurs unpredictably and can deteriorate rapidly and is a medical emergency requiring immediate admission to hospital.

When angina becomes unstable, it is an indication that a blood clot – or thrombus – has formed in the already –narrowed blood vessel and is in danger of totally blocking the heart’s blood supply.  If this were to happen, it would cause a heart attack with consequent irreversible damage to the heart muscle.

The symptoms are similar to those of stable angina – chest pains and/or tightness plus shortage or breath, sweating, pallor and nausea.  However, unstable angina occurs unpredictably, often when the person is at rest and not putting any additional strain on their heart.  A doctor diagnoses angina largely by a person’s description of the symptoms.

The greatest immediate risk is occurrence of a heart attack. Initial treatment is aimed at reducing this risk by administration of drugs that help to prevent the formation of blood clots.

Surgery is an option where drug treatment is ineffective.  This could be a coronary artery bypass graft (CABG) where a section of the leg vein or aortal artery is grafted on to bypass the diseased part of the coronary artery.  Alternatively, coronary angioplasty may be used, where the blocked part of the coronary artery is ‘stretched’ and widened by inserting and then inflating a balloon and is then, in some cases, kept open with a metal ‘stent’.

Maintaining a healthy lifestyle and diet to prevent the tendency of blood to clot or arteries to become 'furry' and blocked, is the most important contribution an individual can make to prevent unstable angina, and other heart conditions.

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