What is Angina?

 

Angina is a type of chest pain caused by reduced blood flow to the heart. Angina is a symptom of coronary artery disease.

Angina, also called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms say angina feels like a vise squeezing their chest or a heavy weight lying on their chest. Angina may be a new pain that needs to be checked by a doctor, or recurring pain that goes away with treatment.

Although angina is relatively common, it can still be hard to distinguish from other types of chest pain, such as the discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away.

 

Symptoms

Angina symptoms include chest pain and discomfort, possibly described as pressure, squeezing, burning or fullness.

You may also have pain in your arms, neck, jaw, shoulder or back.

Other symptoms that you may have with angina include:

  • Dizziness

  • Fatigue

  • Nausea

  • Shortness of breath

  • Sweating

These symptoms need to be evaluated immediately by a doctor who can determine whether you have stable angina, or unstable angina, which can be a precursor to a heart attack.

Stable angina is the most common form of angina. It usually happens when you exert yourself and goes away with rest. For example, pain that comes on when you're walking uphill or in the cold weather may be angina.

 

Characteristics of stable angina

  • Develops when your heart works harder, such as when you exercise or climb stairs

  • Can usually be predicted and the pain is usually similar to previous types of chest pain you've had

  • Lasts a short time, perhaps five minutes or less

  • Disappears sooner if you rest or use your angina medication

 

The severity, duration and type of angina can vary. New or different symptoms may signal a more dangerous form of angina (unstable angina) or a heart attack.

 

Characteristics of unstable angina (a medical emergency)

  • Occurs even at rest

  • Is a change in your usual pattern of angina

  • Is unexpected

  • Is usually more severe and lasts longer than stable angina, maybe 30 minutes or longer

  • May not disappear with rest or use of angina medication

  • Might signal a heart attack

There's another type of angina, called variant angina or Prinzmetal's angina. This type of angina is rarer. It's caused by a spasm in your heart's arteries that temporarily reduces blood flow.

Characteristics of variant angina (Prinzmetal's angina)

  • Usually happens when you're resting

  • Is often severe

  • May be relieved by angina medication

Angina in women

Symptoms of angina in women can be different from the classic angina symptoms. These differences may lead to delays in seeking treatment. For example, chest pain is a common symptom in women with angina, but it may not be the only symptom or the most prevalent symptom for women. Women may also have symptoms such as:

  • Nausea

  • Shortness of breath

  • Abdominal pain

  • Discomfort in the neck, jaw or back

  • Stabbing pain instead of chest pressure

When to see a doctor

If your chest pain lasts longer than a few minutes and doesn't go away when you rest or take your angina medications, it may be a sign you're having a heart attack. Call 000 or emergency medical help. Arrange for transportation. Only drive yourself to the hospital as a last resort.

If chest discomfort is a new symptom for you, it's important to see your doctor to find out what's causing your chest pain and to get proper treatment. If you've been diagnosed with stable angina and it gets worse or changes, seek medical attention immediately.

Causes

Angina is caused by reduced blood flow to your heart muscle. Your blood carries oxygen, which your heart muscle needs to survive. When your heart muscle isn't getting enough oxygen, it causes a condition called ischemia.

The most common cause of reduced blood flow to your heart muscle is coronary artery disease (CAD). Your heart (coronary) arteries can become narrowed by fatty deposits called plaques. This is called atherosclerosis.

During times of low oxygen demand — when you're resting, for example — your heart muscle may still be able to function on the reduced amount of blood flow without triggering angina symptoms. But when you increase the demand for oxygen, such as when you exercise, angina can result.

  • Stable angina. Stable angina is usually triggered by physical activity. When you climb stairs, exercise or walk, your heart demands more blood, but narrowed arteries slow down blood flow. Besides physical activity, other factors such as emotional stress, cold temperatures, heavy meals and smoking also can narrow arteries and trigger angina.

  • Unstable angina. If fatty deposits (plaques) in a blood vessel rupture or a blood clot forms, it can quickly block or reduce flow through a narrowed artery. This can suddenly and severely decrease blood flow to your heart muscle. Unstable angina can also be caused by blood clots that block or partially block your heart's blood vessels.

    Unstable angina worsens and isn't relieved by rest or your usual medications. If the blood flow doesn't improve, your heart is starved of oxygen and a heart attack occurs. Unstable angina is dangerous and requires emergency treatment.