Angina symptoms may sometimes improve with rest, especially in cases of stable angina that are triggered by physical activity or emotional stress. However, recurring angina could be an underlying condition, and you should not rely on it fading on its own.
Angina (Heart Pain) Treatment in Singapore
Dr Eric Hong
Senior Consultant Cardiologist & Internal Medicine Physician
MB BCh (Ireland), MRCP (United Kingdom), FAMS (Cardiology), DIP (CBNC, USA), FSCAI (SCAI, USA), FACC (ACC, USA), FESC (European Society of Cardiology, France), FRCP (Edinburgh, United Kingdom)
MB BCh (Ireland), MRCP (United Kingdom), FAMS (Cardiology), DIP (CBNC, USA), FSCAI (SCAI, USA), FACC (ACC, USA), FESC (European Society of Cardiology, France), FRCP (Edinburgh, United Kingdom)
Have you experienced chest pain, pressure or a feeling of tightness in your chest, especially during physical activity or periods of stress? These symptoms may be signs of angina, a condition that occurs when the heart muscle does not receive enough oxygen-rich blood.
While symptoms may come and go, angina can sometimes indicate an underlying cardiovascular condition that requires medical attention. Recognising the signs of angina and seeking timely medical evaluation can help identify the underlying cause and reduce the risk of more serious heart-related complications.
At EH Heart Specialist, Dr Eric Hong provides comprehensive angina diagnosis and treatment, helping patients receive personalised care to support their long-term heart health.
What Are the Symptoms of Angina?
Angina can present differently from person to person, but it is most commonly felt as discomfort, pressure or pain in the chest. While symptoms are often triggered by physical activity, emotional stress or exertion, they may also occur at rest in some cases.
Common symptoms of angina include:
- Intense chest pain or pressure
- A burning or squeezing in the chest
- Breathing difficulties
- Nausea or vomiting
- Pain that spreads to the shoulders, arms, neck, jaw or back
- Sweating
- Dizziness
- Fatigue
Angina can sometimes feel similar to a heart attack, as both may cause chest pain, tightness or discomfort.
However, angina symptoms are often temporary and may improve with rest or medication. A heart attack
typically causes more severe or persistent symptoms due to a sudden blockage of blood flow to the heart.
Because it can be difficult to distinguish between angina and a heart attack, chest pain or discomfort
should never be ignored. Seek immediate medical attention if symptoms are severe, worsening or do not
improve with rest.
If you are experiencing these symptoms, you should visit a heart pain specialist promptly
What Are the Types of Angina?
Stable Angina
Stable angina is the most common type of angina. Symptoms usually occur when the heart has to work harder than usual, such as during exercise, climbing stairs or periods of emotional stress. The discomfort tends to follow a predictable pattern and often improves with rest or prescribed medication.
Unstable Angina
Unlike stable angina, unstable angina can occur suddenly and without an obvious trigger, even while resting. Symptoms are often more severe, last longer and may become increasingly frequent over time.
Variant Angina
Variant angina is caused by a temporary spasm of the coronary arteries. It often occurs while resting, particularly during the night or early morning hours. It may be triggered by exposure to cold weather, medicine intake, smoking or drug use.
Microvascular Angina
Microvascular angina occurs when the small blood vessels supplying the heart do not function properly. Symptoms can be similar to other types of angina but may last longer and be accompanied by shortness of breath, fatigue or reduced exercise tolerance. It is often associated with coronary microvascular disease.
What Causes Angina?
Most people develop angina due to coronary artery disease. As fatty deposits or plaque accumulate, an artery carrying blood through the heart becomes narrowed or blocked. This results in the onset of a disease known as atherosclerosis. Factors that may lead to this condition include:
Poor Nutrition
Diets high in saturated fats, cholesterol and sugars can contribute to plaque buildup in the arteries, increasing the risk of atherosclerosis and angina.
Lack of Physical Activity
Sedentary lifestyles can lead to obesity and other risk factors such as high blood pressure and high cholesterol, which can cause arterial blockages.
Smoking
Smoking damages the lining of the arteries, promotes plaque buildup and reduces oxygen in the blood, all of which can lead to angina.
Coronary Artery Spasms
These are sudden, temporary tightenings of the muscles within the artery walls, which can reduce or block blood flow to the heart, causing angina.
Diabetes
High blood sugar levels can damage the arteries and promote atherosclerosis, increasing the likelihood of experiencing angina.
Stress-Induced Physical Reactions
Stress can trigger the release of stress hormones like adrenaline, which increases heart rate and blood pressure. This can potentially lead to reduced blood flow to the heart and angina symptoms.
In Singapore, angina treatment is determined by the severity of the patient's condition. In mild cases, lifestyle changes, such as a balanced diet and exercise, may be helpful in managing symptoms. Medications and more invasive procedures are also possible methods of angina treatment in Singapore, which can help increase oxygen delivery to the heart and treat the underlying causes of the condition.
Am I at Risk of Angina?
Angina is more likely to occur when the heart has to work harder or when blood flow to the heart is reduced. Certain health conditions, lifestyle factors and family history can increase your risk, especially when more than one factor is present.
Common risk factors for angina include:
- Family history of heart disease
- Obesity
- Lack of exercise
- Old age
- Diabetes
- High blood pressure
- High blood cholesterol or triglyceride levels
When to See a Chest Pain Doctor in Singapore
A consultation may be beneficial if you have concerns about chest pain, have multiple cardiovascular risk factors or have been experiencing symptoms that affect your daily activities or exercise tolerance.
Seeking medical attention early can help identify whether your symptoms are heart-related and allow any underlying conditions to be diagnosed and managed before they progress.
How Is Angina Diagnosed?
In order to differentiate angina from other non-heart-related causes of chest pain, several diagnostic tests may be performed:
Echocardiography
This test uses sound waves to examine the status of the heart. Results of echocardiography come in 2 and 3-dimensional images of the heart and it can show if blood is flowing properly in the chambers and valves of the heart.
Stress Test
Angina is easier to diagnose when the heart is working harder. During a stress test, the patient’s blood pressure and ECG readings are examined while he or she exercises by walking on a treadmill or pedalling a stationary bicycle.
Electrocardiogram
This procedure records a person’s heartbeat by using an electrical impulse generated from special cells. Through this, the doctor can look for patterns among the heartbeats to see if there is an abnormality in the blood flow through the vessels.
Chest X-ray
Images of the heart and lungs are taken with the help of this test. Chest X-rays can determine if there are existing structural abnormalities.
Coronary Angiography
This X-ray imaging test examines the inside of the heart’s blood vessels. During this procedure, a type of dye that is visible in an X-ray machine is injected into the heart’s blood vessels.
How Do Cardiologists Treat Angina?
Angina treatment can involve oral medications. In more serious cases, an angioplasty or bypass surgery may be required to unblock the arteries and resume normal blood flow.
Medications
- Anticoagulants or Antiplatelet Drugs – These medications help lower the risk of blood clots that can block arteries and cause angina.
- Blood Pressure Medications – Medicines like beta-blockers or calcium channel blockers reduce blood pressure and decrease the heart's workload, helping to lower the risk of angina.
- Cholesterol Medications – Statins and other cholesterol-lowering drugs reduce plaque buildup in the arteries, which can alleviate or prevent angina.
- Medications Used Specifically to Treat Angina – Nitrates and other anti-anginal drugs help relax and widen blood vessels, improving blood flow to the heart.
Therapy
- Enhanced External Counterpulsation (EECP) Therapy – This non-invasive procedure involves wearing cuffs on the legs that inflate and deflate to improve blood flow to the heart, potentially reducing angina symptoms.
Surgical Procedures
- Coronary Artery Bypass Grafting (CABG) – This surgery involves creating a bypass around blocked coronary arteries using a vessel from another part of the body, improving blood flow to the heart muscle.
- Coronary Angioplasty or Percutaneous Coronary Intervention (PCI) – This procedure uses a balloon to widen narrowed or blocked coronary arteries. A stent may then be placed to help keep the artery open, improving blood flow to the heart and reducing angina symptoms.
How to Manage Angina
Many people with angina can live a normal life with proper management. This often involves a combination of lifestyle changes, medication adherence and regular medical check-ups to monitor your heart health.
- Keep a Log of Your Angina Episodes – Take note of your episodes, including the date and time, pain level, what it felt like, and possible triggers. This can help you and your doctor identify patterns and manage the condition more effectively.
- Know When to Call for Emergency Help – If you experience severe chest pain that does not go away with rest or medication, or if the symptoms change or worsen, seek immediate medical attention.
- Take Medications as Prescribed – Ensure you take all medications as directed by your doctor to control angina and lower the risk of episodes.
- Try to Avoid Triggers – Identify and avoid activities, foods or situations that may lead to angina attacks, such as strenuous exercise, emotional stress or heavy meals.
How Can Angina Be Prevented?
One way to reduce the risk of angina is to engage in an active lifestyle and keep a healthy diet.
- Consume a Balanced Diet – Eat a diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats. Avoid excessive intake of saturated fats, trans fats and cholesterol to reduce plaque build-up in the arteries.
- Cut Down on Alcohol – Limit alcohol consumption as excessive drinking can lead to high blood pressure and weight gain, both of which are risk factors for angina.
- Avoid Smoking – Quit smoking and avoid exposure to secondhand smoke. Smoking damages the arteries and reduces oxygen supply to the heart, increasing the risk of angina.
- Maintain an Optimal Weight – Achieve and maintain a healthy weight through diet and exercise. Being overweight increases the heart's workload and can exacerbate angina symptoms.
- Exercise – Engage in low-impact activities like walking, swimming or cycling. Build up your activity level gradually and take regular breaks to avoid overexertion.
Nevertheless, proper consultation and detailed cardiac assessment with a heart specialist first will help greatly in the prevention and treatment of angina and other heart diseases.
At EH Heart Specialist, Dr Eric Hong provides personalised evaluation and treatment recommendations, helping patients understand their condition and the options available for managing angina.
Take the Next Step Towards Better Heart Health
At EH Heart Specialist Clinic, Senior Consultant Cardiologist & Internal Medicine Physician Dr Eric Hong provides comprehensive assessment, diagnosis and treatment for angina and other cardiovascular conditions. With over 20 years of experience in cardiology, he works closely with patients to develop personalised treatment plans that support long-term heart health and well-being.
If you are experiencing chest pain, have concerns about your heart health or would like a professional cardiac evaluation, contact us today to schedule a consultation.
Frequently Asked Questions (FAQs) About Angina
Younger individuals can also develop the condition. Risk factors such as smoking, diabetes, obesity, high cholesterol, high blood pressure and a family history of heart disease can all increase the likelihood of developing angina at a younger age.
Many people with angina can continue to exercise safely with appropriate medical guidance. However, the type and intensity of exercise should be tailored to your condition and symptoms. It is advisable to consult a cardiologist before starting or modifying an exercise programme if you have angina.
Although treatment can help reduce symptoms and improve blood flow to the heart, angina may sometimes return, particularly if the underlying heart condition progresses or cardiovascular risk factors remain unmanaged. Regular follow-up appointments, medication adherence and healthy lifestyle habits can help reduce the likelihood of recurring symptoms and support long-term heart health.
As angina is often a sign that the heart is not receiving enough oxygen, a persistent lack of treatment could lead to worsening symptoms and an increased risk of serious complications such as heart attack, heart failure or other cardiovascular events.
Meet Our Angina (Heart Pain) Specialist in Singapore
Dr Eric Hong
Senior Consultant Cardiologist & Internal Medicine Physician
MB BCh (Ireland), MRCP (United Kingdom), FAMS (Cardiology), DIP (CBNC, USA), FSCAI (SCAI, USA), FACC (ACC, USA), FESC (European Society of Cardiology, France), FRCP (Edinburgh, United Kingdom)
MB BCh (Ireland), MRCP (United Kingdom), FAMS (Cardiology), DIP (CBNC, USA), FSCAI (SCAI, USA), FACC (ACC, USA), FESC (European Society of Cardiology, France), FRCP (Edinburgh, United Kingdom)
Dr Eric Hong Cho Tek is a Singapore-based cardiologist with extensive training in both interventional and imaging-based cardiac care. He completed two ACGME (Accreditation Council for Graduate Medical Education, USA) Clinical Fellowships in Interventional Cardiology and Non-Invasive Cardiac Imaging. His clinical expertise covers cardiac CT angiography, PET/SPECT imaging, and nuclear cardiology, enabling him to offer well-rounded assessments and treatment options. Dr Hong's areas of interest include interventional cardiology (femoral and radial access), sports cardiology, cardiac rehabilitation, and advanced cardiac imaging.