Clinical features: Angina pectoris is an episodic clinical syndrome resulting from transient myocardial ischaemia which is caused by occlusive disease in the coronary arteries usually secondary to atheromas but occasionally due to syphilitic coronary ostial stenosis, coronary embolism or congenital abnormalities in the coronary vessels. The presenting clinical features are a sense of oppression or tightness in the middle of chest which is induced by exercise and is relieved by rest. The oppression or tightness lasts for a few minutes. Prinz-metal variety of angina is experienced without exertion.

Change in Lifestyle

Minimize risk factors with particular attention to:

• cessation of smoking
• weight reduction if obese
• control of hypertension.

Other factors which should be considered and addressed where appropriate include: high blood cholesterol, stressful lifestyle and excessive alcohol intake. Regular moderate exercise should be encouraged.