Angina pectoris, commonly known as angina, is chest pain or discomfort due to ischemia or a lack of blood and oxygen supplying the heart muscle generally due to obstruction or spasm of the coronary arteries, the heart's blood vessels.
A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes completely blocked by a blood clot or plaque.
Coronary artery disease, the main cause of angina, is due to atherosclerosis of the cardiac arteries. (See Coronary Artery Disease). Over time coronary artery disease can lead to heart failure and arrhythmias.
There is a link between the severity of pain and the level of blockage and oxygen deprivation, but sometimes there can be severe pain with little or no risk of a heart attack, and conversely, a heart attack can occur without pain).
Exertion or emotional stress can trigger angina.
Stable & unstable angina
Angina attacks that worsen, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina. Since these can signal an impending heart attack, they require immediate medical intervention.
Stable angina refers to chest discomfort brought on by some activity such as walking or running with an individual experiencing minimal or no symptoms while at rest. Symptoms usually are relieved within minutes when the activity is stopped.
- It may feel like pressure or squeezing in your chest. Sometimes the pain is described as a pressure, heaviness, tightness, squeezing, burning, or choking sensation.
- Angina pain may even feel like indigestion.
- The pain also may occur in your shoulders, arms, neck, jaw, upper central abdomen or back.
- Pain may be accompanied by breathlessness, sweating, nausea, vomiting and pallor in some cases.
Angina risk factors include:
During an attack of angina, the lack of oxygen supply to the heart is temporary and reversible, but if it eventually leads to a heart attack, the dead muscle tissue and damage are permanent. Since angina may be the only warning of an impending heart attack, it is crucial to obtain an accurate diagnosis.
St. Vincent’s cardiologists are expert in the diagnosis of angina and the coronary artery disease underlying it through a thorough physical examination and family history. If further investigation is merited, these doctors can call upon the most advanced diagnostic technology to get to the heart of the problem (see Coronary Artery Disease/Diagnosis for a complete list of the latest diagnostic procedures).
Angina is often treated with oxygen, aspirin or betablocker therapy such as metoprolol or atenolol. Nitrogylcerin is also effective in relieving angina symptoms but may not necessarily reduce the risk of a heart attack.
Much more effective is treating the underlying coronary artery disease through interventional procedures such as angioplasty, drug-eluting stent placement or surgery, that is, coronary artery bypass grafting.
Are you or a loved one experiencing pain, or a tightening in your chest? Don't ignore these signs and symptoms. Anyone, including healthy, young athletes can experience angina that requires immediate attention from a cardiologist. Many people are born with heart conditions that go undetected until it's too late. If you're experiencing angina - please contact your physician for follow-up testing.
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