Angina

If you are experiencing pain or discomfort in your chest, you may be suffering from angina. Angina is squeezing, tightness or pressure experienced in your chest. Angina attack is caused by reduced blood flow to the heart muscle. At times you may also experience pain in the shoulders, arms, neck, jaw, or the back.

Angina is not a disease on its own, but rather a symptom of coronary heart disease (CHD). CHD is one of the most common types of heart disease in adults, which occurs when a substance called plaque builds up around the inner walls of the arteries of your heart. This causes the arteries of the heart to become narrower. Since these arteries primarily carry oxygen to the heart through the bloodstream, the supply of oxygen to the heart then becomes restricted, causing tightness in the chest. Angina may also be a symptom of coronary microvascular disease (MVD), which affects the smallest coronary arteries and is more commonly prevalent amongst women.

There are several causes and risk factors that may trigger an angina attack, such as high blood pressure, being overweight, high cholesterol levels, age, activity levels, family history of heart diseases, smoking, stress and an unhealthy diet.​

You may confuse symptoms of angina pain with indigestion, as both are similar. However, you need to be careful in assessing the difference between the two as angina can be fatal. You need to look out for these common symptoms of angina pain:

  • Chest pain

  • Pain in the jaw, neck and shoulders

  • Shortness of breath

  • Sweating

  • Constant fatigue

  • Dizziness

  • Nausea

  • Vomiting​

​If you are experiencing chest pain that lasts longer than a few minutes, it is recommended that you consult with your physician as soon as possible. The pain may be signalling a heart attack. ​
Your time with your doctor maybe limited, so makes sure to prepare for your visit beforehand. Here ​are some tips to help get you started.​​

​At The Aga Khan University Hospital you can take advantage of the medical expertise of our qualified medical professionals who can help in an accurate diagnosis of your disease. In order to confirm the diagnosis of angina, your doctor at The Aga Khan University Hospital will take a medical history, including a family history of heart diseases. He/she will also ask you about your lifestyle and any applicable risk factors. Based on your symptoms and history, your doctor may conduct one or more of the following tests:

  • ECG or EKG (Electrocardiogram): The procedure will be used to test your heartbeat in order to detect unusual patterns which may indicate a heart attack.

  • Echocardiogram: This procedure will use ultrasound waves to produce images of your heart which will then be examined to check for muscle damage or other abnormalities.

  • Exercise stress test, nuclear stress test and stress echocardiogram: These will help in measuring blood flow to the muscles of your heart when they are at rest as well as during stressful situations such as exercise. In nuclear stress test, a radioactive substance is injected into the bloodstream which mixes with the blood and travels to the heart, where it is detected by a special scanner that creates images of the heart. In stress echocardiogram, ultrasound images of the heart are obtained at rest and during stress, to detect heart wall abnormalities.

  • Chest X-ray: A detailed image of your heart will be captured by an X-ray machine which the doctor will examine in detail to check for irregularities.

  • Blood tests to check for presence of enzymes which could be leaking into the blood.

  • Coronary angiography: The process will use X-ray images to scan the inside of the blood vessels in your heart. A special dye is injected into the blood vessels of your heart which provides a detailed image of your heart. 

  • Cardiac CT (Computerized Tomography) scan: This will provide images of your heart and chest to show if any of the heart's arteries are abnormal.​​​

The Department of Cardiology​ at The Aga Khan University Hospital offer a range medically accredited treatment options for angina. The quality health care services provided at the Hospital include a staff of qualified and trusted medical professionals who can help provide a treatment suited to your needs. 

Angina can be managed in a number of ways. One of the simplest things you can do is make a lifestyle change such as quitting smoking, losing weight, managing your diabetes, avoiding stress, avoid eating rich meals and starting an exercise regime. However, there are several medication options as well, including:

  • Aspirin

  • Clot-preventing drugs

  • Beta blockers

  • Nitrates

  • Statins (drugs used to lower blood cholesterol)

  • Calcium channel blockers (calcium antagonists) which help to relax and widen blood vessels 

  • Novel anti-anginal medications e.g. trimetazidine, nicorandil, ranolazine and ivabradine which can be used as a stand-alone treatment or along with other options

If the aforementioned measures are unable to combat your angina, you can opt for further interventions.  Angioplasty is an invasive, non-surgical treatment during which an un-inflated balloon will be inserted into your blocked artery and then blown up to widen the artery. This will restore the blood flow to the heart, which in turn will restore the oxygen supply. If blockages are severe, surgical option i.e. coronary artery bypass surgery (CABG) can be performed. During a CABG, a vein or artery from another area of your body will be used to bypass a narrowed artery and restore blood and oxygen flow to the heart.

At The Aga Khan University Hospital, bypass surgery using multiple arterial grafts is offered, which lasts longer than bypass with veins or one artery only and results in longer survival. ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider. ​​

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