Coronary artery disease
Chest pain caused by an insufficient blood supply to the heart muscle is known as angina, and is usually caused by narrowing of the coronary arteries that supply blood to the beating heart. This narrowing is caused by a build-up of fatty deposits in the walls of the arteries, known as atherosclerosis. During exercise, when the heart beats faster, the heart muscle is unable to get enough oxygen from the reduced blood supply, causing pain. The typical symptoms of an angina attack are an ache or tightness across the front of the chest, occasionally going into the jaw, neck or arms. Angina can also cause shortness of breath.
An angina attack should not last more than 10 minutes. More prolonged bouts of chest pain, or symptoms on minimal exertion, may suggest unstable angina or a heart attack. Both are medical emergencies and require urgent medical attention. Less commonly, angina may be caused by a problem with the heart valves or muscle. Over a million people between the ages of 35 and 75 suffer from angina, while around 100,000 people have a heart attack in the UK each year – over 60 per cent of them male. A study of almost 10,000 male civil servants found that those who reported that they often did considerable amounts of cycling or other vigorous sports experienced less than half the coronary heart disease of men who didn’t.
In established angina, the British Heart Foundation recommends lowering high blood pressure, weight, blood cholesterol and stress. Medication will usually be prescribed, but regular cycling also has a positive impact. Many people worry about straining the heart and are reluctant to exercise, but physical activity helps to get the heart fitter and improves the blood supply to the heart muscle. If angina is caused by a problem with a heart valve, such as the aortic valve, exertion isn’t recommended until the valve has been treated. It is important that a medical professional establishes the cause of all new cases of angina and starts appropriate treatment. In stable angina it is often possible to predict the level of exertion that will bring on pain, so gradually increase the duration or difficulty of rides and ease off if necessary. If you’ve been prescribed medication to stop an attack (eg glyceryl trinitrate – GTN – spray) carry it with you.
After a heart attack cycling can usually be commenced after six weeks, but check with a health professional or cardiac rehabilitation specialist first. Seek urgent medical advice if your exercise tolerance drops off, and chest pains come sooner than usual.