Matters of the heart: triggers, signs and symptoms of angina

Heart health was top of mind on World Heart Day, marked on September 29 2020. Those with underlying heart conditions are at significantly higher risk of Covid-19, which is why awareness around heart health is arguably more important than ever.

Sunday Times Connect, in partnership with Servier and the SA Heart Association recently hosted a digital conversation on the triggers, signs and symptoms of angina. Moderated by Joanne Joseph, panellists included Dr David Jankelow, SA Heart Association president and a clinical cardiologist at the Netcare Linksfield Clinic, and Dr Martin Tawanda Butau, a cardiologist in private practice and former head of the cardiology unit at Port Elizabeth Provincial Hospital. 

Angina is a type of chest pain caused by reduced blood flow to the heart — a warning sign that something may be wrong. Stable angina is brought about by a particular amount of activity and resolves quickly with rest, is controlled with medication and does not become more frequent or severe. If the pattern of chest discomfort worsens or changes over a short period of time for the first time or to the previously stable angina, then the unstable angina could potentially be a signal of a heart attack. 

Angina manifests differently in everybody. Some of the typical symptoms include the following: tightness; heaviness or chest pain, which can spread to the arms, neck, jaw, shoulders, back or stomach; dizziness; fatigue; nausea; shortness of breath; and sweating. 

For some the pain can be severe, others may feel no more than mild discomfort or pressure. Symptoms typically disappear after a few minutes of rest or after taking prescribed medication. It can be difficult to distinguish between normal chest pain and a heart attack. “When in doubt about the cause of unexplained chest pain, seek medical assistance as quickly as possible,” said Butau. 

The most common cause of angina is coronary heart disease. Those who smoke, have high blood pressure, high blood cholesterol levels, are overweight or obese, don’t exercise enough or have diabetes, are at greater risk of coronary heart disease. However, a family history could also predispose an individual to coronary heart disease. 

“If your father, brother, uncle or grandfather had angina or a heart attack before the age of 55, or your mother, sister, aunt or grandmother had angina or a heart attack before the age of 65, you may be at risk of premature heart disease,” said Butau, adding that angina cannot be cured but that it can be managed. 

Coronary heart disease claims 250 lives each day in SA and about 80-million lives globally each year, said Jankelow. Preventing these diseases requires more education and awareness around the factors that can be controlled. This requires stopping smoking; monitoring health conditions such as high blood pressure, cholesterol and diabetes; following a healthy diet and maintaining a healthy weight; reducing stress levels; limiting alcohol consumption; and getting an annual flu shot to avoid heart complications from the flu virus. Added to this is regular exercise.

“The recommendation is for 150 minutes of moderate activity each week made up of 30 minutes of exercise five times a week,” he said, adding that 50% of people are not adhering to the prescribed health guidelines. 

Watch the full digital event below:

This article was paid for by Servier and the SA Heart Association.