Angina
Information on angina such as what is angina, what causes angina and the signs and symptoms of angina.
Over six million people in the United States have angina. People with coronary artery disease (CAD) or who have had a heart attack are more likely to have angina.
What is Angina?
Angina is chest pain or discomfort that feels like pressure or a squeezing pain in the chest. The pain may also be in the shoulders, arms, neck, jaw, back or it may also feel like indigestion. This occurs when the heart muscle does not get enough blood. Angina is a symptom of CAD which occurs when plaque builds up in the coronary arteries. As this occurs, the coronary arteries become narrow and stiff reducing blood flow to the heart and decreasing oxygen to the heart muscle.
Three types of angina:
- Stable angina: This is the most common type and occurs when the heart is working harder than usual. It consists of a regular pattern, the pattern can be recognized and predicted and the pain goes away in a few minutes after rest or angina medicine. Stable angina is not a heart attack, but it is more likely that the person will have one in the future.
- Unstable angina: This is a very dangerous condition that requires immediate emergency treatment. It occurs without a pattern and does not go away with rest or medicine. Unstable angina is a sign that a heart attack could occur soon.
- Variant angina: This is rare, it occurs at rest and is relieved by medication. The pain can be severe and generally occurs between midnight and early morning.
What causes Angina?
Angina is caused by reduced blood flow to an area of the heart ?Ĭ generally due to CAD. Sometimes other types of heart disease or uncontrolled high blood pressure can cause angina. Generally the coronary arteries (carry blood to the heart) become narrowed due to the buildup of fatty deposits called plaque (atherosclerosis). Some of the plaque is hard and stable which leads to narrowed and hardened arteries, where as some plaque is soft and may break open causing blood clots. The buildup of plaque on the inner walls can cause angina by either narrowing the artery so blood flow is reduced or forming clots that partially or totally block the artery.
Three types of angina:
Stable angina: The most common cause of stable angina is physical exertion. This is because there is an increase need for blood flow for activities such as walking up a hill or climbing stairs. Other causes include emotional stress, very hot or cold temperatures, heavy meals and smoking.
Unstable angina: This is caused by blood clots that partially or totally block an artery. The clot may grow large enough to completely block the artery and cause a heart attack. These clots can form, partially dissolve and later form again.
Variant angina: This is caused by a spasm in a coronary artery. This narrows the artery causing blood flow to slow or stop. Variant angina may occur in people with or without CAD. Other causes of spasms are exposure to cold, emotional stress, medications, cigarette smoking and cocaine use.
Signs and Symptoms
Common symptoms of angina pain include:
- Pressure, squeezing, burning, or tightness in the chest
- Generally starts in the chest behind the breastbone
- May also occur in the arms, shoulders, neck, jaw, throat, or back
- May feel like indigestion
Some people say that angina pain is hard to describe or they can not tell where it is coming from. Other symptoms such as nausea, fatigue, shortness of breath, sweating, light-headedness, or weakness may also occur.
Symptoms vary based on the type of angina. Stable angina pain or discomfort:
- Occurs when the heart must work harder, usually during physical exertion
- Is expected, and episodes of pain tend to be alike
- Usually lasts a short time (5 minutes or less)
- Is relieved by rest or angina medicine
- May feel like gas or indigestion
- May feel like chest pain that spreads to the arms, back, or other areas
Unstable angina pain or discomfort:
- Often occurs at rest, while sleeping at night, or with little physical exertion
- Is unexpected
- Is more severe and lasts longer (as long as 30 minutes) than stable angina episodes
- Is usually not relieved with rest or angina medicine
- May get continuously worse
- May signal that a heart attack will happen soon
Variant angina pain or discomfort:
- Usually occurs at rest and during the night or early morning hours
- Tends to be severe
- Is relieved by angina medicine
Information gathered 3-24-05.