Angina is a type of chest pain caused by reduced blood flow to the heart. Angina (an-JIE-nuh or AN-juh-nuh) is a symptom of coronary artery disease.
Angina, which may also be called angina pectoris, is often described as squeezing, pressure, heaviness, tightness or pain in your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest or feeling like a heavy weight has been placed on their chest. Angina may be a new pain that needs evaluation 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 pain or discomfort of indigestion. If you have unexplained chest pain, seek medical attention right away.
Angina symptoms include:
These symptoms need to be evaluated immediately by a doctor who can determine whether you have stable angina, or unstable angina that may indicate a possible 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 is often angina.
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.
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.
A woman's angina symptoms 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 experience symptoms such as:
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 911 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 stable angina gets worse or changes, seek medical attention immediately.
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.
This reduced blood flow is a supply problem â your heart is not getting enough oxygen-rich blood. You may wonder why you don't always have angina if your heart arteries are narrowed due to fatty buildup.
This is because during times of low oxygen demand â when you're resting, for example â your heart muscle may be able to get by on the reduced amount of blood flow without triggering angina symptoms. But when you increase the demand for oxygen, such as when you exercise, this can cause 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, suddenly and severely decreasing 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 deprived of oxygen and a heart attack occurs. Unstable angina is dangerous and requires emergency treatment.
To diagnose angina, your doctor will start by doing a physical exam and asking about your symptoms. You'll also be asked about any risk factors, including whether you have a family history of heart disease.
There are several tests your doctor may order to help confirm whether you have angina:
Stress test. Sometimes angina is easier to diagnose when your heart is working harder. During a stress test, you exercise by walking on a treadmill or pedaling a stationary bicycle.
While exercising, your blood pressure is monitored and your ECG readings are watched. Other tests also may be conducted while you're undergoing stress testing. If you're unable to exercise, you may be given drugs that cause your heart to work harder to simulate exercising.
Nuclear stress test. A nuclear stress test helps measure blood flow to your heart muscle at rest and during stress. It is similar to a routine stress test, but during a nuclear stress test, a radioactive substance is injected into your bloodstream.
This substance mixes with your blood and travels to your heart. A special scanner â which detects the radioactive material in your heart â creates images of your heart muscle. Inadequate blood flow to any part of your heart will show up on the images because not as much of the radioactive substance is getting there.
Coronary angiography. Coronary angiography uses X-ray imaging to examine the inside of your heart's blood vessels. It's part of a general group of procedures known as cardiac catheterization.
During coronary angiography, a type of dye that's visible by X-ray machine is injected into the blood vessels of your heart. The X-ray machine rapidly takes a series of images (angiograms), offering a detailed look at the inside of your blood vessels.
The chest pain that occurs with angina can make doing some normal activities, such as walking, uncomfortable. However, the most dangerous complication is a heart attack.
If you have any of these symptoms, seek emergency medical attention immediately.
You can help prevent angina by making the same lifestyle changes that might improve your symptoms if you already have angina. These include:
Because heart disease is often the cause of angina, you can reduce or prevent angina by working on reducing your heart disease risk factors. Making lifestyle changes is the most important step you can take.
The following risk factors increase your risk of coronary artery disease and angina: