What is angina pectoris?
Blood carries oxygen and nutrients necessary for your heart to work properly.
Angina pectoris—"angina" for short—is chest discomfort likely caused by diminished blood flow, and therefore diminished oxygen to your heart.
Plaque, a fatty material that builds up inside of one or more of the arteries that carry blood to your heart, causes a partial or complete blockage of the blood flow. (Think about a garden hose that has a lot of scaly build up inside of it, which restricts the flow of water.) This plaque buildup, called atherosclerosis, interferes with the flow of blood to your heart over time.
Symptoms and types
Angina pectoris symptoms can be obvious or subtle. It causes chest pain in the form of heaviness, tightness, pressure, aching, burning, numbness, fullness or squeezing. It may also feel like heartburn or indigestion, and any form of angina discomfort may be constant or come and go. The chest discomfort may be accompanied by shortness of breath with minimal exertion (such as walking across a room), nausea, sweating or fatigue.
There are several types of angina, and the signs and symptoms depend on which type you have. The types of angina are stable, unstable, microvascular, and variant.
- Stable angina usually follows a pattern, such as discomfort occurring after exercise or when you are under stress. The pain usually goes away after you rest or take angina medicine. If these symptoms occur for at least two months, you may have stable angina.
- Unstable angina may occur with or without physical exertion, and rest or medication may not relieve the pain. (Stable angina could become unstable angina.) Unstable angina is a medical emergency—someone experiencing it should go to the ER.
- Microvascular angina affects the tiny arteries of the heart and can be stable or unstable.
- Variant angina is rare and occurs when the muscles within the arteries of your heart spasm or tighten, interrupting blood flow, instead of or in addition to plaque buildup. This type of angina usually occurs while you are at rest, and often happens between midnight and early morning. Medicine often eases variant angina effectively.
Risks
Typically, providers only screen for angina when you have symptoms. Still, providers routinely screen for angina risk factors—and recommend preventive strategies based on those which can be modified.
Risk factors include:
- Advancing age (risk increases for men after 45, and for women after 55)
- Family history of early heart disease
- Unhealthy cholesterol levels
- High blood pressure
- History of smoking
- Diabetes or metabolic syndrome
- Being overweight, obese or eating an unhealthy diet
- Inactivity
If you are experiencing chest pain regularly—even if you don’t have many risk factors—see a health care provider. Depending on its cause, angina can be treated with medications or surgery, but untreated unstable angina can lead to a medical emergency.
Published on March 31, 2020
Sources:
Centers for Disease Control and Prevention Heart disease. About Heart Disease. https://www.cdc.gov/heartdisease/about.htm Retrieved 1/23/2020
UpToDate. Mahler, S. (2019) Angina pectoris: Chest pain caused by fixed epicardial coronary artery obstruction. Retrieved 1/23/2020
National Institute of Health National Heart, Lung and Blood Institute. Angina https://www.nhlbi.nih.gov/health-topics/angina Retrieved 1/28/2020
American Heart Association. Angina https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain Retrieved 1/28/2020