Angina


What is angina?

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


What causes angina?

Angina is caused by reduced blood flow to the heart muscle. Blood carries oxygen which the heart needs to survive. When the heart muscle does not get enough oxygen, it causes a condition called ischemia. Those changes can lead to a sensation of chest discomfort or pain.


What are the types and symptoms of angina?

The most common symptom is chest pain usually behind the breast bone or to the left of it. Symptoms of chest pain may feel like tightness, heavy pressure, squeezing, or crushing pain. The discomfort may radiate to the arms (usually left arm), back, jaw, neck, or shoulders. Sometimes the discomfort is described as gas pain or indigestion/heart burn. At times, an individual may feel dizzy or lightheaded, nausea with or without vomiting, palpitations, shortness of breath, fatigue, or sweats.


There are a few different types of angina:

Stable Angina occurs when patients experience chest pain that is triggered by activity. The discomfort is usually predictable. Once the activity is stopped, or an individual slows down, the symptoms usually improve and go away. The pain usually begins slowly and worsens over time before going away. The pain lasts an average of 1-15 minutes and can be relieved with rest or medication called nitroglycerine.

Unstable Angina occurs when chest discomfort comes on at rest. The pain or discomfort frequently occurs without a cause and is not relieved with rest. It could be associated with low blood pressure or shortness of breath. This type of angina is usually a warning sign that a heart attack may happen soon. It needs to be addressed right away.

Variant (Prinzmetal’s) Angina is often described as a spasm. It may or may not be associated with symptoms of chest pain but if the spasm lasts long enough, risk of heart attack is higher. The symptom of chest pain is usually described as constricting, crushing, pressure, squeezing, and/or tightness. The symptoms usually occurs at rest, may occur the same time each day (usually between midnight and 8:00 am), and lasts from 5 to 30 minutes. An individual may also have associated symptoms of syncope or near syncope. Symptoms may occur with or without activity.


What is the treatment for angina?

Treatment options may include lifestyle changes, medications, and procedures such as coronary angioplasty, stent placement, and/or in the worst cases, bypass surgery can improve chest discomfort. Other medications can be used to prevent angina from getting worse such as beta-blockers, calcium channel blockers, and ranolazine.