Angina

Angina is chest pain or discomfort that happens when the heart muscle doesn't get enough blood, usually because of narrowed heart (coronary) arteries. It is a warning sign — not a heart attack — but it signals significant heart disease and needs evaluation.

Typical features

• A pressure, tightness, or heaviness in the centre of the chest — often described as "someone sitting on my chest."
• May spread to the left arm, jaw, neck, upper back or tummy.
• Triggered by physical effort, heavy meals, cold weather, emotional stress or sex.
• Usually lasts a few minutes and eases with rest.
• May come with breathlessness, sweating, nausea.

Types

• Stable angina — predictable with exertion; eases with rest.
• Unstable angina — new, more frequent, at rest, or not settling — medical emergency, dial 112.
• Variant (Prinzmetal) angina — spasm of the artery; often at rest.

Red flags — dial 112

• Chest pain lasting more than 15-20 minutes.
• Chest pain not relieved by rest.
• New severe chest pain at rest.
• Chest pain with cold sweat, nausea, breathlessness, fainting.
• These suggest heart attack, not "just" angina.

Why Indians should take angina seriously

Indian patients develop heart disease around a decade earlier than Western populations. Symptoms are sometimes atypical in Indian women, people with diabetes and older adults — for example, only unusual fatigue or shortness of breath, without classic chest pain. Any new exertional discomfort above the waist that keeps coming back deserves a Health Expert visit.

Diagnosis

• ECG (often normal between episodes).
• Stress test (treadmill or with imaging).
• ECHO.
• Coronary angiography — gold standard to see the arteries directly, done when tests suggest significant blockage.

Treatment

• Lifestyle: quit smoking, daily walk, healthy weight, manage BP/diabetes/cholesterol.
• Medicines to ease symptoms, lower cholesterol, lower BP and prevent clots — taken daily.
• Angioplasty with stent — for significant blockages in suitable arteries.
• Bypass surgery (CABG) — for multiple or complex blockages.