Cardiac Conditions & Diseases

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What Is Angina?

Angina (an-JI-nuh or AN-juh-nuh) is chest pain or discomfort that occurs when an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.

Angina isn't a disease; it's a symptom of an underlying heart problem. Angina usually is a symptom of coronary heart disease (CHD), also called coronary artery disease.

CHD is the most common type of heart disease in adults. It occurs if a fatty material called plaque (plak) builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart.

Plaque narrows and stiffens the coronary arteries. This reduces the flow of oxygen-rich blood to the heart muscle, causing chest pain. Plaque buildup also can lead to a heart attack if the plaque ruptures (breaks open) and causes a blood clot to form that blocks the artery.

Angina also can be a symptom of coronary microvascular disease (MVD). This is heart disease that affects the heart’s smallest coronary arteries. Unlike traditional CHD, coronary MVD doesn’t always create blockages in the arteries. Studies have shown that coronary MVD is more likely to affect women than men.

Coronary MVD also is called cardiac syndrome X and nonobstructive CHD.

Types of Angina

The types of angina are stable, unstable, variant (Prinzmetal's), and microvascular. Knowing how the types differ is important. This is because they have different symptoms and require different treatments.

Stable Angina

Stable angina is the most common type of angina. It occurs if the heart is working harder than usual. Stable angina has a regular pattern.

If you know you have stable angina, you can learn to recognize the pattern and predict when the pain will occur. The pain usually goes away a few minutes after you rest or take your angina medicine.

Stable angina isn't a heart attack, but it suggests that a heart attack is more likely in the future.

Unstable Angina

Unstable angina doesn't follow a pattern. It can occur with or without physical exertion, and it may not be relieved by rest or medicine.

Unstable angina is very dangerous and requires emergency treatment. This type of angina is a sign that a heart attack may happen soon.

Variant (Prinzmetal's) Angina

Variant angina is rare. It usually occurs while you're at rest, and the pain can be severe. Variant angina usually happens between midnight and early morning. Medicine can relieve this type of angina.

Microvascular Angina

Microvascular angina can be more severe and last longer than other types of angina; medicine may not relieve it. This type of angina may be a symptom of coronary MVD.

Overview

Experts believe that nearly 7 million people in the United States suffer from angina. About 400,000 people go to their doctors with new cases of angina every year. The condition occurs equally in men and women.

Angina can be a sign of heart disease, even if initial tests don't show evidence of CHD. However, not all chest pain or discomfort is a sign of a heart problem.

Other conditions also can cause chest pain, such as a pulmonary embolism (a blockage in a lung artery), a lung infection, aortic dissection (tearing of a major artery), pericarditis (inflammation in the tissues that surround the heart), or a panic attack.

All chest pain should be checked by a doctor.

Information provided by National Heart Lung and Blood Institute