Angina is a heart condition that can feel similar to a heart attack. Unlike a heart attack, the pain usually goes away in 15 minutes or less with rest or medication. Angina can signal an increased risk of heart attack. Like all chest pain, it should be checked out by a doctor.
What is Angina?
Angina occurs when the coronary arteries that bring oxygen-rich blood to the heart muscle are clogged with a fatty substance called plaque.
A person with angina often experiences pain, burning, tightness, or pressure in the chest, back, neck, throat, or jaw which generally only lasts for a few minutes. Angina is a warning sign that the heart isn't getting the oxygen it needs and that you are at increased risk of having a heart attack.
Angina may be brought on by:
- Exertion (though it can also strike when you are resting)
- A large meal
- Emotional upsets
- Smoking or other triggers
Risk factors for angina include:
- High blood pressure
- Cigarette smoking
- High blood cholesterol levels
- Excess weigh
- History of heart disease
At St. Joseph's Heart & Vascular Institute, we offer a number of preventative health programs and tools for our patients.
Types of Angina
There are three types of angina:
Stable angina is the most common type and occurs when the heart is working harder than usual. This can occur during:
- Physical exertion or emotional stress
- Extreme cold or heat
- After eating a heavy meal or drinking alcohol
- Cigarette smoking
Unstable angina is a very dangerous condition that requires emergency treatment. It is a sign that a heart attack could occur soon. It is caused by blood clots that partially or totally block an artery. Chest pain can occur each time a clot blocks an artery. Unlike stable angina, it does not follow a pattern.
Variant angina is rare. It is caused by a spasm in a coronary artery, and it usually occurs at rest. It can occur in people who do not have coronary artery disease.
Symptoms of Angina
While angina can feel similar to a heart attack, the pain from usually goes away in 15 minutes or less with rest or medication.
Angina can cause any of the following symptoms:
- A crushing, squeezing, burning pain in the chest
- A feeling of pressure or heaviness in the chest
- Pain radiating to jaw, arms, neck and/or back
If you have symptoms that you can't explain or angina that lasts more than a few minutes, call 9-1-1 or go to the emergency room right away.
Types of Chest Pain Caused by Angina
There are two main types of chest pain associated with angina:
Atypical chest pain is often sharp and comes and goes. You can feel it in your left chest, abdomen, back or arm. It is unrelated to exercise and not relieved by rest or medicine. It is more common in women.
Typical chest pain feels heavy or like someone is squeezing you. You feel it under your breast bone. The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
Not all chest pain or discomfort is angina, but all chest pain should be checked out by a doctor. Chest pain or discomfort can be caused by a heart attack, lung problems such as an infection or a blood clot, musculoskeletal problems, heartburn or a panic attack.
Diagnosis of angina is based on a medical exam, your symptoms and your risk factors. Additionally, your doctor may use the following tests to confirm whether you have angina:
- Electrocardiogram (ECG)
- Stress test
- Chest X-ray
- Nuclear stress test
- Coronary angiography
- Blood tests
- Cardiac computerized tomography (CT) scan
Treatment Options for Angina at St. Joseph's Heart & Vascular Institute
Angina treatments aim to decrease the attacks and severity of symptoms and prevent heart attacks. At St. Joseph's Heart & Vascular Institute, our first priority is treating the underlying cause of angina – coronary artery disease – by controlling risk factors.
Our treatment options include:
Medication: The most commonly prescribed drug for angina is nitroglycerin, which provides temporary relief of chest pain by widening blood vessels, allowing more blood to flow to the heart muscle and decreasing the heart's workload. It is not a long-term therapy.
Calcium channel blockers and beta blockers: These medications lower blood pressure by relaxing blood vessels, slowing slow heart rate and reducing the heart's output of blood.
Coronary angioplasty: This minimally invasive procedure opens up clogged arteries.
Coronary artery bypass graft surgery: This surgical procedure restores blood flow to your heart by redirecting blood flow around a blocked artery.