So, in simple terms, the difference between
a heart attack and angina is that in a heart attack one has interrupted the blood supply
to the heart for long enough that some portion of the heart muscle has died, whereas in angina,
one has a temporary or short-term reduction of the blood supply to the heart to the point
that there is some discomfort, but there is no permanent damage. If we think of it in
terms of the vessels of the heart, in a normal person, this is what the vessel looks like.
We’ve got a thin layer of muscle and a lining that is nice and thin that would cope with
exercised very nicely and you’ll have no problem doing exercise from the heart point of view.
Over time, if one’s cholesterol is a bit high and smoking and things like that, cholesterol
or fat can lay down within the artery and partially block the artery. These arteries
can supply enough blood to the heart when you’re at rest generally, but when you try
to exercise, there’s not sufficient blood getting through these and that causes discomfort
or tightness in the chest when you’re exercising. By contrast, when it comes to heart attacks,
a clot has formed on that fat and has blocked the vessel. Because no blood can now get
through to the muscle beyond that, that territory will die if that’s not relieved. So normally
we would admit somebody immediately to hospital and unblock that vessel with angioplasty and
a stench. So, from a point view of thinking about it, angina is typically a tightness
in the chest. It comes on with exercise, it’s relieved by rest and if you try to
keep exercising, it will stop you. It usually disappears within five minutes. By contrast, a heart attack
which is clearly much more serious, people often describe as an elephant on the chest, they
are very compressed. It often comes on when they’re doing
absolutely nothing and the pain lasts for longer than 20 minutes. Whenever chest heaviness lasts longer than 20 minutes,
it’s time to call an ambulance.