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By May 11, 2015 - 4:04am

Recently I have had some pain in my chest. My doctor says it could be angina and wants me to see a heart specialist for tests. What is angina and what will these tests involve?

Angina is a heart pain which occurs when the blood supply to the heart is insufficient because of narrowing of the coronary arteries. It is usually brought on by exercise, because that is when the heart needs most blood, but if the narrowing of the arteries is very severe, it may happen at rest. If one of the arteries becomes completely blocked, this leads to a heart attack. It is sometimes possible to improve the coronary circulation, either by inserting a small tube called a stent or by an operation to bypass the blockage.

The heart specialist may want to carry out various tests which may include asking you to walk on a treadmill while recording your heart tracing. He or she may also want to inject dye into the coronary arteries to identify the site of the blockage. This is normally done by inserting a tube into your groin area using a local anaesthetic. If it is not possible to correct the blockage, there are a number of treatments available which can widen the coronary arteries and prevent blood clots.

My husband died recently from a heart attack. He had had diabetes for 72 years and was controlled on tablets, and at about the same time that he developed diabetes he started having angina attacks. I wondered whether these were related and whether poor control had anything to do with his fatal heart attack?

There is certainly a connection between heart disease and diabetes. It has been shown that control of high blood pressure, cholesterol and blood glucose are all effective in preventing heart disease.

I am in my early twenties, but haven’t had good diabetes control for a couple of years. Will this affect my arteries in later life?

It is unlikely to have much effect at your age but if you continue to have poor control over the next few years, you are likely to build up trouble for the future. Our arteries get more rigid and more clogged up as we get older and this process can be aggravated by periods of poor diabetes control and by smoking.

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My left leg has been amputated because I developed diabetic gangrene. I now get a lot of pain in my right foot and calf. Could too much insulin be the cause of this pain?

It sounds as if the blood supply to your leg is insufficient and that this is the cause of the pain in your right foot and calf. As you know, this is the reason you developed gangrene in your left leg and you must be very worried about your right leg. You should tell your doctor about the pain as you may need to be referred to a vascular surgeon to see if anything can be done to improve the blood supply to your foot.

There are a number of things you can do to help protect your remaining leg and these include:

stopping smoking (if you smoke);
keeping diabetes, blood pressure and cholesterol under very good control;
maintaining close contact with a podiatrist who has a special interest in diabetes.

If you notice any sign of increased pain or change in colour, you should seek medical advice immediately.

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