Angina

Angina Pectoris: Symptoms, Types of Chest Pain, and Treatments Image

Angina, or angina pectoris, is chest pain caused by arteries that have narrowed to a point that they can no longer deliver enough blood to meet the heart’s demands.

Types of Angina

Angina can be classified as one of two types.

Stable Angina: People with stable angina experience symptoms of angina as a result of factors such as exercise or a heavy meal. Stable angina is predictable and generally lasts no longer than five minutes. Rest and nitroglycerin usually are enough to relieve the symptoms.

Unstable Angina: People with unstable angina have no predictable pattern of symptoms. Symptoms often occur while a person is resting, and rest or nitroglycerin often fails to relieve the symptoms. The symptoms also are more severe than those of stable angina. Unstable angina is not the same as a heart attack, but is an acute coronary syndrome and should be treated as an emergency.

Causes of Angina

Coronary artery disease is the most common cause of angina. In coronary artery disease, the coronary arteries—those responsible for delivering blood and oxygen to the heart—are narrowed by a buildup of cholesterol and calcium deposits. With narrowed arteries, the heart is unable to receive an adequate supply of blood.

Other causes of angina include injury, inflammation or infection of the arteries, which may also cause blood clots, or narrowed arteries.

Variant Angina

Variant angina, or Prinzmetal’s angina, is a form of unstable angina, but the cause is different. In variant angina, the heart muscle contracts in spasms, causing nearby arteries to temporarily narrow or close off. This briefly reduces blood flow to the heart, resulting in angina symptoms.

Variant angina symptoms almost always occur at rest and are particularly common between midnight and 8 a.m.

Treatment for variant angina usually consists of nitroglycerin and calcium channel blockers.

Symptoms of Angina

Symptoms of angina include:

  • discomfort or pain in the chest
  • radiating pain in the neck, shoulders, arms, neck, jaw or back
  • shortness of breath
  • dizziness
  • fainting
  • sweating
  • nausea
  • a rapid or irregular heartbeat
  • a feeling of impending doom.

You might notice that angina symptoms are identical to heart attack symptoms. Distinguishing between an angina attack and a heart attack is actually quite difficult.

Angina symptoms are usually temporary, while heart attack symptoms tend to linger. Also, for people with stable angina, rest or nitroglycerin relieves the symptoms. People experiencing a heart attack often find no relief from rest or nitroglycerin.

Chest Pain: Other Causes?

Chest pain doesn’t always signal an angina attack or a heart attack. A number of other conditions may result in chest pain, including:

  • sore chest muscles
  • a respiratory infection
  • asthma
  • gastroesophageal reflux disease (GERD)
  • pulmonary embolism.

Angina Pectoris Treatments

Treatments for angina depend on the type and severity of the angina. For most people with stable angina, symptoms disappear after a period of time. Rest and nitroglycerin may be sufficient to treat the attack.

For people with unstable angina, other medications such as antiplatelet medications, beta blockers, calcium channel blockers and blood thinners may be given.

In severe cases of angina, or where the risk of a heart attack is high, surgical procedures such as a coronary artery bypass grafting and percutaneous transluminal angioplasty may be recommended.

Resources

Alaeddini, J., Alimohammadi, B.