SYMPTOMS: Pain or tightness beneath the breast bone that builds over several minutes across the chest. May extend to the arms, jaw, neck or stomach.
It’s often mistaken for indigestion and can occur during exertion or stress, but should ease if you rest. If it’s more severe than usual or lasts longer than 15 minutes, call an ambulance.
WHAT IS IT? Angina is usually caused by the narrowing of the coronary arteries to the heart muscle. It occurs because blood supply to the muscle is reduced.
It’s a warning sign that you probably have coronary heart disease and should always be taken seriously.
HOW IS IT TREATED? Glyceryl Trinitrate (GTN), usually taken in pill form, causes the blood vessels to rapidly dilate and increases blood flow again in a minute or two.
To prevent angina, patients are often prescribed beta blockers, (bisoprolol/atenolol) or calcium channel blocker, (diltiazem/verapamil), both of which slow the heart rate and help to reduce blood pressure.
If angina is severe, patients may be offered angioplasty – here, a tiny tube with a balloon at the end is passed through a blood vessel in the groin up to the heart.
When the balloon reaches the correct place, it is blown up, expanding the narrowed section of a coronary artery to keep it open.
INSIDER TIP: For immediate relief, a GTN spray (available on prescription) can be taken via the mouth and unlike the pill, it doesn’t taste bitter.
Some post-menopausal women suffer from a type of angina called Syndrome X – even though their arteries are normal. It often goes undiagnosed, but up to 60 per cent of sufferers are disabled by it.
HRT prescribed by a specialist cardiologist may help to reduce or prevent symptoms (oestrogen helps dilate the arteries).
High blood pressure
SYMPTOMS: Sometimes headaches, dizziness, shortness of breath and blurred vision. However, often there are no symptoms, which is why it is called a ‘silent killer’.
One in three adults has high blood pressure – which is why adults should have it checked regularly (at least every three to five years; in older people it should be at least once a year).
WHAT IS IT? When the arteries become tougher and less elastic, more pressure is needed to pump the blood around the body. It’s just as if you squeezed a hosepipe – the water pressure behind your hand builds up.
HOW IS IT TREATED? Patients are treated with a range of drugs including angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers, which make the artery walls relax, and angiotensin receptor blockers (or ARBs) to control the hormones that affect blood pressure.
It is unlikely you would be prescribed all three, but you may well get two. Increasing exercise levels and reducing weight, salt intake and excessive stress are also beneficial.
INSIDER TIP: Statins to reduce levels of cholesterol in the blood.
Diuretics, which cause the body to excrete excess fluid and put less strain on the heart, are used less frequently now, partly because of their side effects, including erectile dysfunction in men.
Check with your GP before drinking grapefruit juice, as it can interact with some blood pressure medication.
Irregular heart beat
SYMPTOMS: Your heartbeat feels erratic and rapidly speeds up, so you’re more aware of it. The force of each beat can vary in intensity and you might feel dizzy and breathless and experience chest pain. Some patients also suffer blackouts.
WHAT IS IT? Missing a heartbeat happens to a lot of people when they’re under stress or have drunk too much coffee, but this is nothing to worry about.
However, prolonged irregular heartbeat, known as arrhythmia (felt as a palpitation), should be investigated.
One form of arrhythmia, atrial fibrillation, when the heart’s normal beat is interfered with by random electrical impulses, is remarkably common. In many people, the problem goes undiagnosed.’
HOW IS IT TREATED? Beta blockers may be given to slow the heart rate and blood thinners such as warfarin to prevent clotting (if the heart isn’t beating regularly, clots can form in the heart’s left chamber, where blood can pool).
For more severe symptoms, the heartbeat can be normalised with an electric shock therapy – direct current cardioversion.
If symptoms persist, the treatment is with cardioablation – destroying the area sending the faulty electrical impulses with heat from a catheter.
INSIDER TIP: The most powerful drug to convert people out of arrhythmia – sometimes permanently – is amiodarone.
It’s a specific anti-arrhythmic drug which works differently from beta blockers. But it can cause thyroid and eye problems so must not be used for long periods.
SYMPTOMS: Sufferers may experience chest pain and breathlessness, or no symptoms at all.
WHAT IS IT? The heart muscle grows too thick (or too thin), making it too weak to pump blood around the body. There are several forms – hypertrophic cardiomyopathy is hereditary and is linked to sudden deaths in young adults (all the family should then be screened).
Other types include congestive cardiomyopathy which can be triggered by alcoholism or viruses.
HOW IS IT TREATED? Beta blockers, ACE inhibitors and diuretics. Patients with hypertrophic cardiomyopathy can sometimes be treated with an operation called myomectomy, where surgeons core out the heart muscle to make it thinner, but it has mixed results.
INSIDER TIP: People considered at high risk of sudden death can have tiny defibrillators connected directly to the heart. These send electrical impulses into the affected heart muscle when it goes into arrthymia.
This is a pretty good solution, and at least you know you have another layer of protection should your heart suddenly stop beating.
Heart valve disease
SYMPTOMS: Early symptoms include chest pain (constant or sporadic), as the damaged heart valve constricts the flow of blood through the heart. May later cause blackouts and breathlessness.
WHAT IS IT? The left side of the heart pumps out oxygenated blood around the body. It contains two internal valves, the aortic valve and the mitral valve. Both can become diseased, as a result of rheumatic fever, bacterial infection or simple wear and tear.
Tens of thousands of people have heart valve disease and ,many need their valves replaced every year.
This disease can be treated by having the valve replaced with a metallic valve, but patients then have to take warfarin for life
HOW IS IT TREATED? If the problem is due to bacterial infection, antibiotics can help. But the infection will often have already destroyed the valve, so it will need replacing.
Metallic valves are most hardwearing, but patients need to take warfarin for life to prevent clots forming on the valve.
Animal tissue valves are increasingly being used for this reason (patients need only aspirin),Post published in: Analysis