Angina is a group of symptoms that happen when there’s not enough blood flow to your heart. Angina can occur in a chronic stable pattern that is controllable with lifestyle modifications and medicine, but angina can also occur in an unstable pattern, and during an acute heart attack.
Let’s look at the most common angina symptoms.
Angina Symptoms
Angina can present with many different types of symptoms, and in many different combinations of those symptoms. Most commonly angina presents as chest pain, but it can also feel like a chest pressure, chest burning, or chest squeezing. Some people have described it as a chest discomfort, or even a chest “misery.” There may be an abnormal sensation/discomfort/pain in your shoulders, arms, neck, back, and/or belly. Angina may also be accompanied by shortness of breath, nausea and/or vomiting, profuse sweating, and extreme fatigue and/or weakness. Some people only get one of the symptoms, and some get a few or many of them at once.
What Causes Angina?
Angina occurs when cholesterol plaques build up around our coronary arteries and cause them to narrow. The coronary arteries deliver oxygen-rich blood to the heart; when heart arteries get blocked or narrowed, your heart muscle doesn’t receive the oxygen it needs to function. When the heart muscle is deprived of oxygen-rich blood, it sends signals to the brain telling it that there is a problem occurring with the heart. The symptoms mentioned above then start to occur. A heart attack occurs if the blocked blood flow occurs for a long enough period of time (just a few minutes) that the heart muscle begins to die.
Note: Not all chest symptoms are heart related. Other serious conditions can cause chest symptoms. They include:
- Tearing of a major artery.
- Lung artery blockage.
- Collapsed lung
- Heart valve disease.
- Heart viral infection.
- Inflammation of tissues surrounding heart and/or lungs.
- Lung infection.
- Disease/dysfunction in the belly
- Injuries
You should call 911 if you have chest symptoms lasting more than a few minutes that don’t go away with rest or medicine.
Types of Angina
There are two important types of angina:
- Stable angina — When the symptoms mentioned above occur in a predictable pattern when performing any type of exertion, to include walking, exercising, doing household chores and so forth, and they go away with a few minutes of rest, the angina is deemed to be stable. An example of stable angina would be a person that walks for exercise, and after 10 minutes of walking they get an angina symptom that goes away with a couple of minutes of rest, and this happens every time they do their walk. If this has been their usual pattern, this would be termed “Stable Angina.” Stable angina can be treated with medicine and lifestyle modifications, such as proper diet, tobacco avoidance, and a supervised exercise program. If angina occurs at rest, or is a new symptom, or begins to occur more frequently with less exertion than expected, or begins to last longer than expected, it then becomes “unstable angina.”
- Unstable angina — the most serious type of angina, it typically occurs without warning, often without physical exertion. It can also be when previously stable angina begins to worsen or change, or if the angina with exertion is a new symptom never felt before. If it doesn’t go away with rest or medicine it is a sign that a heart attack is possibly occurring.
Angina and Heart Attack
Angina is a symptom of your heart not getting enough blood; a heart attack occurs when reduced blood flow goes on for so long that the heart muscle begins to die. Angina that does not go away can be a signal that the heart muscle is dying.
You may be having a heart attack if:
- Resting doesn’t ease your discomfort.
- The pain doesn’t go away in a few minutes or keeps getting worse.
- Your angina medication isn’t helping to ease your discomfort.
If you have angina for more than a few minutes, call 911. Do not drive or have someone else drive you to the hospital.
Angina Risk Factors
The risk factors for angina are like the risk factors for heart disease.
- Being older than 45 for men and older than 55 for women.
- Being overweight or obese.
- Diabetes.
- A diet high in saturated fat and salt.
- Family history of early heart disease.
- High blood pressure.
- High cholesterol
- Lack of exercise.
- Menopause in women.
- Smoking.
How Do Doctors Diagnose and Treat Angina?
If you have chest pain, your doctor will ask about your symptoms and family history. If they suspect you have heart disease, they may run one or more of the following tests:
- Electrocardiogram (EKG).
- Echocardiogram (heart ultrasound)
- Blood tests.
- Chest x-rays.
- Stress test.
- Coronary CAT scan
- Coronary angiography.
Treatment for angina may include:
- Lifestyle changes. Your doctor may recommend more physical activity and a heart-healthy diet, and quitting nicotine products.
- Medicine to help open the arteries. The most common one is nitroglycerin, a drug that relaxes blood vessels and increases blood flow to the heart; also includes other medicines such as beta blockers and calcium channel blockers.
- Medicines to treat risk factors such as high blood pressure, diabetes, and high cholesterol.
- If the above fail, or artery blockages are in particularly critical arteries, you may get a procedure to open the blocked arteries, such as coronary stents, or to detour around the blockages with open heart coronary bypass surgery.
Preventing Angina
In many cases, preventing heart disease and angina is possible. Some people are genetically prone to heart problems, but you can minimize your risk factors by making certain lifestyle choices. You and your doctor can work together to incorporate healthy changes into your routine.
These lifestyle tweaks may include:
- A heart-healthy diet. Eating more lean protein, whole grains, healthy fats, fruits, and vegetables can help heart health. At the same time, try to limit red and cured meats, processed foods, sugary snacks, and foods high in salt.
- A plan to quit smoking. The American Heart Association says that your risk of heart disease drops by 50% within one year after you quit smoking. Talk to your doctor about finding a program to help you quit tobacco.
- Regular exercise. Brisk walking or other moderate aerobic activity (about 30 minutes, five times a week) can help prevent heart disease. Mix in resistance or weight training a couple of times a week for even better results.
- Talking to your doctor about your specific risk factors. They can give you the best advice on living a heart-healthy lifestyle.