Angina

What Is Angina?

More than 6 million Americans live with angina pectoris, or angina for short. Angina is chest pain or discomfort that occurs when the heart muscle is not getting enough oxygen-rich blood for a short time. The inadequate blood flow is caused by narrowed coronary arteries, which are the blood vessels that supply blood to the heart. A bout of angina is not a heart attack, but it means that you're more likely to have a heart attack than someone who doesn't have angina.

 

Understanding the Heart and Coronary Arteries

In order to understand the cause of angina, it is often helpful to understand the heart and the coronary arteries. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. Similar to other muscles, the harder the heart is working, the more oxygen and nutrients it needs. However, the coronary arteries can become narrowed or clogged, which can decrease the amount of blood that goes to the heart muscle. When the coronary arteries cannot supply enough oxygen-rich blood to the heart, angina symptoms can occur.

 

Types of Angina

There are three types of angina:

 

Stable angina is the most common type. It occurs when the heart is working harder than usual. There is a regular pattern with this condition. After several episodes, you learn to recognize the pattern and can predict when it will occur. The pain usually goes away in a few minutes after you rest or take your angina medicine.

Unstable angina is a dangerous condition that requires emergency treatment. It is a sign that a heart attack could occur soon. Unlike stable angina, it does not follow a pattern. It can occur without physical exertion and is not relieved by rest or medicine.

 

Variant angina is rare; it usually occurs at rest. The pain can be severe and usually occurs between midnight and early morning. This pain can usually be relieved by medicine.

 

Causes of Angina

Angina is caused by a temporary lack of oxygen-rich blood to the heart muscle. This decrease in blood flow can happen for a number of reasons and will vary, based on the type. Most commonly, the cause of angina is coronary artery disease (CAD), or what most people refer to as just heart disease. Sometimes, other types of heart disease (such as aortic stenosis) or uncontrolled high blood pressure (hypertension) can cause angina.

 

What Triggers It?

For a lot of people (especially those with stable angina), symptoms are triggered by:

 

Unstable and variant angina are usually not associated with triggers.

 

Risk Factors

Specific angina risk factors include:

 

Stable and unstable angina occurs more often in older adults. People with variant angina are often younger than those with other forms of the condition.

 

Symptoms of Angina

People experiencing an angina attack usually feel discomfort (often a pressure-like pain) in or around the:

 

 

It may feel like a squeezing, pressing sensation in the chest. This pain usually lasts two to five minutes.

 

Other angina symptoms can include:

 

Not all chest pain is angina. Many other conditions can cause chest discomfort or pain, such as:

 

 

Angina Versus a Heart Attack

An episode of angina is not a heart attack, but it does mean that you have a greater chance of having a heart attack. The pain associated with angina means that some of the heart muscle temporarily is not getting enough blood. A heart attack, on the other hand, occurs when the blood flow to a part of the heart is suddenly and permanently cut off, usually by a blood clot. This can lead to serious heart damage.

 

There are some serious symptoms that indicate you are having a heart attack. If you have any of these symptoms, call 911 immediately:

 

How Is It Diagnosed?

In order to make an angina diagnosis, your healthcare provider will ask a number of questions; perform a physical exam, looking for signs and symptoms; and recommend certain tests and/or procedures. These procedures are administered to:

 

Treatment for Angina

Treatment for angina can include lifestyle changes, medications, and special procedures. The treatment you and your doctor decide on will likely depend on your overall health, the extent of your angina, and your risk of problems in the future.

 

The goals of treatment are to:

 

Lifestyle changes and medicine may be the only treatments needed if your symptoms are mild and are not getting worse. However, unstable angina is an emergency condition that requires treatment in the hospital.

 

Preventing Angina

There is an old saying that an ounce of prevention is worth a pound of cure. This is definitely the case with angina. Since this is a largely preventable disease, a person can lower his or her chances of developing it through knowledge and choices. Knowledge is defined as understanding angina and the risk factors for it and heart disease; choices are defined as making good decisions to control heart disease and angina risk factors.

 

Regardless of your age, background, or health status, you can lower your risk for angina -- and it doesn't have to be complicated. Protecting your heart can be as simple as taking a brisk walk, whipping up a good vegetable soup, or getting the support you need to maintain a healthy weight.

 

And the good news: Research shows that people can lower their risk for heart disease and angina enormously -- by as much as 82 percent -- simply by adopting sensible health habits. It's never too late to start protecting your heart health. A recent study shows that among people ages 70 to 90, leading a healthy lifestyle reduces the chances of dying from heart disease by nearly two-thirds.