About the heart and its vessels. The heart is made up of a special type of muscle called myocardium. The heart acts as a pump, taking the blood to all parts of the body. The coronary arteries are special arteries which deliver nutrients and oxygen to the heart muscle. Under normal circumstances, oxygen demand by the heart equates that of oxygen supply by the coronary vessels.

Why do I get angina? Angina occurs when one or more of the coronary vessels are narrowed. As a result of that, the heart muscle receives less oxygen than it needs for it to pump normally. The blood supply may be adequate when you are at rest, however, this may not be adequate when your heart starts to pump faster. For instance, when you start to climb stairs or walk uphill. As the heart rate increases, oxygen demand increases, however, blood could not get past the narrowed arteries and, as a result of that, your heart 'screams' with pain.

What causes narrowing of the coronary arteries? The narrowing of the coronary arteries is usually caused by atheroma. In short, atheroma means fatty deposits, which forms in the lining of the arteries. Atheroma does not form overnight, it takes time, usually years for an atheroma to get to a decent enough size to narrow the arteries and therefore cause symptoms.

How do I know that I'm affected by angina? The commonest symptom is pain or discomfort, heavy in nature which crosses the front of your chest, occurring on exertion. Sometimes the pain may extend to your arm, neck or jaw. To confuse things even further, angina may sometimes be described as abdominal pain, although uncommon. Angina usually does not last long, usually for one to two minutes and rarely goes beyond 10 minutes. Exertion, eating, or other causes of a faster heart rate may exacerbate the pain. The pain usually disappears when you rest or if you use some GTN. Certain people may experience angina in a different way, for example, heartburn or a pulled muscle in the chest, which makes diagnosis difficult.

How should I be tested for angina? Angina is usually a clinical diagnosis, however, your doctor may advise you to take up certain tests which may include:

. A blood test. To test for anaemia, cholesterol, thyroid hormones, heart enzymes as all these may be related to angina.
. An ECG (electrocardiogram). A symptom-free ECG may be normal. However if your heart is stressed in one way or another, an abnormal ECG may be evident.
. Other tests may or may not be necessary include angiography and echocardiogram.

Who are at risk of getting angina? Risk factors of angina include people who:

. Are diabetic
. Have hypertension
. Smoke cigarettes
. Have a high cholesterol
. Have a first degree relative with angina or heart attack

What can I do to help with the pain? Certain things can be done to reduce the frequency and severity of angina, they include:

. Stopping smoking if you are a smoker.
. Making sure that your blood pressure is under control if it is high.
. Making sure that your blood cholesterol is under control if it is high.
. Making sure that your diabetes is under control if you are a diabetic.
. Losing some weight if you are overweight.