Like other muscles, the heart needs more oxygen when it exercises/contracts. As the heart is constantly contracting it requires a constant and large supply of oxygen. Coronary arteries are blood vessels that supply oxygen and vital nutrients to the heart, and ensure that the heart has a sufficient supply of oxygen to meet the demands placed upon it. In people with angina, these vessels are narrowed and cannot supply the oxygen required fast enough, therefore the efficiency of the heart is reduced. This leads to an imbalance between the amount of oxygen supplied and the amount of oxygen needed by the heart, in other words Angina. The pain experienced during angina is due to the heart muscle becoming short of oxygen.
The pain experienced during angina starts in the middle of the chest and may then spread to the back, neck, upper jaw, and arms (usually the left arm). The pain is usually heavy rather than sharp or piercing. One way the heart differs from the skin and the brain, is that it does not have "specialised pain nerves- and the sufferer has no prior experience of pain felt within the heart. Therefore, angina sufferers often have difficulty describing the pain experienced during an attack. .
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Most often, angina comes on suddenly in response to exercise and lasts only a short time. The symptoms can often easily be relieved by a prescribed spray or tablets and also can be relieved by simply resting until the pain subsides. There is some short term' medication, such as Nitro lingual spray and Anginine tablets, which contain nitrates, which relaxes blood vessels. Nitro lingual spray delivers a measured dose of nitrate into your mouth. The droplets are absorbed quickly, giving an immediate effect, whereas Anginine, given in tablet form, is absorbed into the bloodstream from the lining of the mouth. It does not work if it is swallowed whole. (Guidelines for Cardiac Rehabilitation and Secondary Prevention Programmes, 1999) .
