Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is
a symptom of heart disease. Angina happens when there is not enough blood flow to
the heart muscle.
This is often a result of narrowed blood
vessels, usually caused by hardening of the arteries (atherosclerosis).
can be dangerous. So it is important to pay attention to your symptoms, know what
is typical for you, learn how to control it, and understand when you need to
What are the symptoms?
angina include chest pain or pressure, or a strange feeling in the chest. Some people
feel pain, pressure,
or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders
or arms. Other
symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness
weakness, or a fast or irregular heartbeat.
Some people describe their angina
as pressure, heaviness, weight, tightness, squeezing,
discomfort, burning, or dull aching in the chest. People often put a fist
to the chest when describing their pain. Some people may feel tingling or numbness
in the arm,
hand, or jaw when they have angina.
It might be hard for you to point to
the exact location of your pain. Pressing on the chest wall does not cause
Your symptoms might begin at a low level and
then increase over several minutes to reach a peak. Angina that starts with an
activity usually will decrease when the activity is stopped. Chest pain that
begins suddenly or lasts only a few seconds is less likely to be angina.
Do not wait if you think you are having a heart attack. Getting help
fast can save your life. Even if you're not sure it's a heart attack, have it
What are the types of angina?
Stable angina means that you can usually
predict when your symptoms will happen. You probably know what things cause your angina.
For example, you know how much activity usually causes your angina.
symptoms happen when your heart is working harder and needs more oxygen
be delivered through the narrowed arteries. Angina may happen when you are:
strenuous exercise (especially if you typically do not
Being exposed to cold temperatures.
intense emotions, such as anger or fear.
Eating a heavy
Using cocaine or amphetamines.
The pain goes away when
you rest or take nitroglycerin. It may
continue without much change for years.
Unstable angina is unexpected. It is a change in your usual pattern
of stable angina. It happens when blood flow to the heart is suddenly slowed by narrowed
vessels or small blood clots that form in the coronary arteries. Unstable angina
symptoms are like heart attack symptoms. It is an emergency. It may happen at rest
or with light activity. It does not go away with rest or nitroglycerin.
caused by coronary artery spasms
Less common types of angina are caused by
coronary artery spasms. This angina happens when a coronary artery suddenly contracts
oxygen-rich blood flow to the heart muscle. If severe, a spasm can block blood flow
and cause a heart attack. Most people who have these spasms have coronary artery
disease, though they don't always have plaque that narrows their arteries.
spasms can be caused by smoking, cocaine use, cold weather, an electrolyte imbalance,
and other things. But in many cases, it isn't known what triggers
Vasospastic angina, also called Prinzmetal's
angina or variant angina, is one type of angina that is caused by coronary artery
spasm. It has a distinctive pattern. It usually occurs when you're resting. It often
happens at the same time each day. For example, it often happens at night or in the
early morning. Symptoms are typically mild at first, then get worse, and then get
less intense. An episode may last about 15 minutes. Nitroglycerin can relieve symptoms.
How do you manage stable angina?
Most people who
have stable angina can
control their symptoms by taking medicines as prescribed and nitroglycerin
Other health problems, such as fever or infection, anemia,
or other heart problems, can make your angina symptoms worse. They may also cause
Angina may get worse when another condition:
your heart to work harder, which
increases the amount of oxygen it needs.
Decreases the amount of
oxygen the heart receives.
In either case, there is an imbalance between
the amount of oxygen
that your heart needs and the amount that it receives through the blood supply
from your coronary arteries. If your heart can't get enough oxygen, your
symptoms of stable angina may get worse.
Beltrame JF, et al. (2017).
International standardization of diagnostic criteria for vasospastic angina. European
Heart Journal, 38(33): 2565-2568. DOI: 10.1093/eurheartj/ehv351. Accessed January
Montalescot G, et al. (2013). 2013 ESC guidelines on the management
of stable coronary artery disease. European Heart Journal, 34(38): 2949-3003. DOI:
10.1093/eurheartj/eht296. Accessed April 13, 2017.
ByHealthwise Staff Primary
Medical ReviewerRakesh K. Pai, MD, FACC - Cardiology,
Electrophysiology E. Gregory Thompson, MD - Internal
Medicine Martin J. Gabica, MD - Family Medicine Adam Husney, MD - Family Medicine Steven
J. Atlas, MD, MPH - Internal Medicine Specialist
Medical ReviewerStephen Fort, MD, MRCP, FRCPC - Interventional
This information does not replace the advice of a doctor.
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