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Complications of Diabetes

Angina in people who have diabetes

What is Angina?

Angina is a term to describe chest pain, which occurs due to coronary artery disease (furring up of the blood vessels which supply the heart).

The nature of the pain may vary from person to person, but usually consists of a discomfort, heaviness or tightness felt in the central chest. The pain may spread to the neck, jaw, shoulders and one or both arms.

Typically these symptoms of angina are brought on by exertion and relieved by rest. However, other factors such as stress and emotional upset, eating a heavy meal, sudden exposure to cold weather commonly brings on angina as well. In some patients angina is entirely unprovoked and occurs at rest.

 Angina is a warning symptom. It should never be disregarded and if you think you may have angina, you should inform your doctor as soon as possible.

What other symptoms am I likely to have?

Angina is associated with other symptoms which are listed below.

  • breathlessness
  • sweating
  • dizziness
  • anxiety

Is chest pain always due to Angina?

No, there are numerous other causes of chest pain.  Common problems include muscular pain arising from the chest wall and pain due to indigestion.

What is the cause of Angina?

Your heart is a pump which pumps blood around your body. The muscles which form the chambers of the heart work continuously and require a good supply of oxygen and nutrients which is delivered by a network of blood vessels. Sometimes these blood vessels become ‘furred-up’ and narrowed due to deposition of fat in the vessel walls over a long period of time. This is known as atherosclerosis.

When the heart works harder during exercise, the blood flow along these narrowed vessels is not able to keep up with the increased demands of the heart. When this happens, your heart becomes short of oxygen and nutrients, causing chest pain to develop.

Why do arteries get ‘furred-up’?

The process of atherosclerosis begins at an early age and continues throughout life. People with diabetes are more likely to develop atherosclerosis. Other risk factors for atherosclerosis include

  • high levels of blood cholesterol
  • smoking
  • high blood pressure
  • sedentary lifestyle
  • overweight

Angina runs in families. If an immediate family member has had angina or a heart attack, this is thought to increase your likelihood of developing this problem.

What can I do to reduce my ‘risk’ of coronary heart disease?

There is a lot you can do to delay or prevent the onset of Angina. These include:

  • smoking cessation
  • changes in diet and lifestyle
  • regular exercise
  • treatment of diabetes and high blood pressure
  • cholesterol lowering therapy when appropriate
  • use of Aspirin when appropriate

Have a chat with your doctor who will be able to advise you of the options most suitable for you.

I’ve heard that Alcohol can help – is this true?

There is some evidence that drinking small amount of alcohol in the region of 2-3 units each day may protect the heart. The advice from the British Heart Foundation states that you should not start drinking just to protect your heart!

How is Angina treated?

In the UK it is now recommended that people with angina should be treated with aspirin, cholesterol lowering drugs, beta blockers. Your doctor will discuss these treatments further with you.

Other more invasive ways of treating angina include coronary angioplasty and bypass surgery.

 

Dr Nishan Wijenaike,
Consultant Physician
West Suffolk Hospitals Diabetes Service
Original article October 2002
Updated November 2007