About Angina- Angina is a type of chest pain or discomfort that occurs when the heart muscle does not receive enough oxygen-rich blood. It most commonly happens because the arteries supplying blood to the heart become narrowed or blocked, usually as a result of coronary artery disease (CAD). Angina is not a disease itself but a warning sign of an underlying heart problem. It may feel like pressure, squeezing, heaviness, tightness, burning, or fullness in the chest. The discomfort may also spread to the arms, shoulders, neck, jaw, back, or upper abdomen. Angina can occur during physical activity or emotional stress, when the heart needs more oxygen. It may improve with rest or prescribed medication. However, some forms of angina can occur unexpectedly and may indicate a serious reduction in blood flow to the heart. New, severe, worsening, or unexplained chest pain should be evaluated urgently because it can sometimes be a sign of a heart attack.
The symptoms of angina can vary from person to person. Common symptoms include:
Chest pain, pressure, tightness, heaviness, or discomfort
Pain or discomfort spreading to the arm or arms
Pain in the shoulder, neck, jaw, back, or upper abdomen
Shortness of breath
Sweating
Nausea or vomiting
Fatigue or unusual tiredness
Dizziness or lightheadedness
Weakness
A feeling of indigestion, heartburn, or fullness in the upper abdomen
Some people, particularly older adults, women, and people with diabetes, may have less typical symptoms. They may experience shortness of breath, fatigue, nausea, back or jaw discomfort, or dizziness without obvious chest pain.
1) Stable Angina- Stable angina is the most common type. It usually occurs when the heart has to work harder, such as during:
Walking or exercising
Climbing stairs
Emotional stress
Exposure to cold weather
Heavy meals
The symptoms generally follow a predictable pattern and often improve with rest or prescribed medication.
2) Unstable Angina- Unstable angina is more serious. It may occur suddenly, even while resting, and may be more severe, frequent, or prolonged than usual. Unstable angina can be a sign that a blood clot or a worsening blockage is significantly reducing blood flow to the heart. It is considered a medical emergency because it can progress to a heart attack.
3) Variant (Prinzmetal) Angina- Variant angina, also called Prinzmetal angina, occurs because of a temporary spasm of a coronary artery. It can occur while a person is resting, often at night or in the early morning.
4) Microvascular Angina- Microvascular angina affects the small blood vessels of the heart. A person may experience chest pain even when the major coronary arteries do not show significant blockage on conventional testing.
The most common cause of angina is coronary artery disease (CAD). In CAD, fatty deposits called plaques build up inside the coronary arteries. This process, known as atherosclerosis, can narrow the arteries and reduce blood flow to the heart muscle. Other possible causes or contributing factors include:
Temporary spasm of a coronary artery
Disease affecting the small blood vessels of the heart
Several factors can increase the risk of coronary artery disease and angina.
Important risk factors include:
Smoking or tobacco use
High blood pressure
High cholesterol
Diabetes
Obesity or being overweight
Lack of physical activity
Unhealthy diet
Increasing age
Family history of heart disease
Chronic stress
Excessive alcohol consumption
Kidney disease
Previous heart disease or stroke
Some risk factors cannot be changed, such as age and family history. However, many lifestyle-related risk factors can be reduced through appropriate medical care and healthy habits.
Call for emergency medical help immediately if chest pain:
Is severe or sudden
Occurs for the first time
Occurs while resting
Lasts longer than a few minutes or does not improve with rest
Is becoming more frequent or severe
Is accompanied by severe shortness of breath
Is associated with sweating, fainting, severe weakness, or dizziness
Spreads to the arm, shoulder, back, neck, or jaw
Occurs in someone with known heart disease and feels different from their usual symptoms
These symptoms may indicate a heart attack or another serious heart condition. Do not attempt to drive yourself to a hospital if you may be having a heart attack. Seek emergency medical assistance.
A doctor will usually begin by asking about the nature, location, duration, and triggers of the chest discomfort. A medical history and physical examination are also performed. Depending on the symptoms and risk factors, tests may include:
Blood tests may be used to check cholesterol, blood sugar, anemia, and other conditions. If a heart attack is suspected, cardiac biomarkers such as troponin may be measured.
A stress test evaluates how the heart performs when it is working harder. Exercise or medication may be used to increase the heart’s workload while the heart is monitored.
During coronary angiography, contrast dye is introduced into the coronary arteries and X-ray images are taken. It can show significant narrowing or blockage and may also help guide treatment.
Treatment depends on the type and severity of angina and the underlying cause. The main goals are to improve blood flow to the heart, reduce symptoms, prevent complications, and lower the risk of heart attack.
Eating a balanced diet rich in vegetables, fruits, whole grains, and other heart-healthy foods
Limiting saturated and trans fats
Maintaining a healthy weight
Exercising regularly as advised by a healthcare professional
Controlling blood pressure
Managing diabetes
Controlling cholesterol
Limiting alcohol
Managing stress
Getting adequate sleep
People with diagnosed heart disease should discuss an appropriate exercise program with their healthcare professional before starting strenuous activity.
If a coronary artery is significantly narrowed, a procedure called percutaneous coronary intervention (PCI) may be recommended. A balloon is used to open the narrowed artery, and a stent may be placed to help keep it open.
For some people with severe or extensive coronary artery disease, coronary artery bypass grafting (CABG) may be recommended. A surgeon creates a new pathway for blood to flow around blocked coronary arteries.
Many cases of angina related to coronary artery disease can be prevented or reduced by controlling cardiovascular risk factors. Helpful measures include:
Angina occurs when the heart muscle temporarily receives insufficient blood and oxygen. A heart attack occurs when blood flow to part of the heart muscle is severely reduced or blocked for long enough to cause damage to the heart muscle. Although stable angina often follows a predictable pattern, new or worsening chest pain should never be assumed to be harmless. If you are unsure whether chest discomfort is angina, a heart attack, indigestion, or another condition, seek urgent medical evaluation.
If you experience recurrent or unexplained chest pain, you may need evaluation by a healthcare professional.
Cardiologist -A cardiologist specializes in diagnosing and treating diseases of the heart and blood vessels. This is usually the primary specialist for suspected angina.
Cardiac Surgeon-A cardiac surgeon performs surgical procedures such as coronary artery bypass surgery when surgery is required.
Emergency Medicine Doctor- An emergency medicine doctor evaluates and treats sudden or potentially life-threatening chest pain, including suspected heart attack or unstable angina.
Critical Care Doctor- A critical care doctor may be involved when severe heart disease or complications require intensive care.
Angina can indicate underlying coronary artery disease and should not be ignored. Stable angina may be manageable with appropriate treatment, while unstable or new-onset angina can be a medical emergency.
Stable angina may improve with rest or prescribed medication, but this does not mean the underlying heart problem has gone away. Medical evaluation is important to identify and treat the cause.
Although angina is more common with increasing age, younger people can also develop it, particularly when they have risk factors such as smoking, diabetes, high cholesterol, high blood pressure, or a strong family history of premature heart disease.
Yes. Women may be more likely to experience symptoms such as shortness of breath, nausea, unusual fatigue, back pain, or jaw discomfort in addition to or instead of typical chest pressure.
Angina can often be effectively controlled by treating its underlying cause and reducing cardiovascular risk factors. Some people may require medicines, angioplasty and stenting, or bypass surgery.
No. Chest pain can have many causes, including heart, lung, digestive, muscle, and other conditions. However, potentially serious heart-related causes must be ruled out when appropriate.
Pain that spreads to the arm, jaw, shoulder, back, or neck
New or worsening symptoms
Reduced ability to perform activities that you previously tolerated comfortably
Seek emergency medical attention for sudden, severe, persistent, or worsening chest pain, especially when accompanied by sweating, shortness of breath, nausea, fainting, or pain spreading to the arm, jaw, back, or shoulder.
Medical Disclaimer: This article is intended for general educational and informational purposes only. It should not be used as a substitute for professional medical advice, diagnosis, or treatment. Chest pain can sometimes be a medical emergency. If you have sudden, severe, persistent, or unexplained chest pain, seek emergency medical attention.
