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Angina is a heart condition that occurs when the coronary arteries that bring oxygen-rich blood to the heart muscle are clogged with a fatty substance called plaque. A person with angina often experiences pressure or pain that comes and goes in the chest. Angina is a warning sign that the heart isn't getting the oxygen it needs.
There are two main types of chest pain:
- Atypical chest pain often sharp and comes and goes. You can feel it in your left chest, abdomen, back or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women.
- Typical chest pain feels heavy or like someone is squeezing you. You feel it under your breast bone. The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.
Angina is divided into three types:
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When does angina happen? Angina usually happens during activity. It can also occur when you're upset or after a large meal.
If angina starts occurring more frequently, lasts longer, or causes more discomfort, you may have unstable angina. It's a sign that your heart problem may be getting worse.
- a crushing, squeezing, burning pain in the chest
- a feeling of pressure or heaviness in the chest
- pain radiating to jaw, arms, neck and/or back
Angina can feel similar to a heart attack. However, unlike a heart attack, the pain from usually goes away in 15 minutes or less with rest or with the use of nitroglycerin prescription medication that comes tablets, or as a spray. Angina may be brought on by exertion, a large meal, emotional upsets, smoking or other triggers. It can also strike when you are resting.
What should I do if I experience an angina attack? Not all chest pain or discomfort is angina, but all chest pain should be checked out by a doctor. Chest pain or discomfort can be caused by a heart attack, lung problems such as an infection or a blood clot, musculoskeletal problems, heartburn or a panic attack.
Call your provider's office immediately if your attacks become more frequent, last longer or feel different or more painful than normal, or if chest pain wakes you from sleep. Talk with your provider if you find you're having angina after expending less effort than usual. If angina pain is intense, dial 9-1-1 and get to the emergency room.
How is angina treated? The goals of angina treatment are to decrease the attacks and severity of symptoms, and to prevent heart attacks.
The first priority is treating the underlying coronary artery disease that causes angina. This is done by controlling existing risk factors, including high blood pressure, cigarette smoking, high blood cholesterol levels and excess weight. If you have diabetes, your health care provider will stress keeping your blood sugar under good control.
Physicians often prescribe medication to treat angina. The most commonly prescribed drug for angina is nitroglycerin, which belongs to a group of drugs called nitrites. These drugs provide temporary relief of chest pain by widening blood vessels, allowing more blood to flow to the heart muscle and decreasing the heart's workload. Oral or sublingual nitroglycerin is prescribed for angina attack and is not a long-term therapy. Nitroglycerine is also available as a dermal patch and a long-acting oral medication; these can reduce the incidence and severity of angina over a 12- to 24-hour period.
Other treatments for angina include calcium channel blockers and beta blockers that reduce blood pressure. Calcium antagonists lower blood pressure by reducing calcium entry into vascular smooth muscle cells, relaxing blood vessels. Beta blockers slow heart rate and reduce the heart's output of blood.
Your health care provider will look at your medical history and other needs to find the right regimen to treat your angina.
If controlling risk factors and medication do not reduce the frequency of angina attacks, your health care provider may recommend balloon angioplasty, a procedure to widen narrowed arteries, or coronary artery bypass graft surgery to improve blood supply to the heart muscle.
What self-care steps can I take for angina? The following steps are usually recommended for angina. Keep in mind that your doctor knows you and understands your medical needs. Therefore, it is more important to follow your doctor's advice than these guidelines.
- Sit down before taking medicine - nitroglycerin can occasionally cause light-headedness. You must let nitroglycerin tablets dissolve completely under your tongue; do not swallow tablets. If you use nitroglycerine spray, take one spray on or under your tongue.
- If you still have chest pain after 5 minutes, take another tablet, or spray inside your cheek again.
- If after another 5 minutes you are still having chest pain, take a third dose of nitroglycerin. Remember to let the tablets dissolve completely.
- After 3 doses of nitroglycerin over a 15-minute period, your chest pain should be relieved. If chest pain continues, you could be having a heart attack and should call 9-1-1.
Angina is pain, burning, tightness, or pressure in the chest, back, neck, throat, or jaw which generally only lasts for a few minutes. It signals a lowered amount of blood flow to the heart. Angina is a sign that you are at increased risk of having a heart attack.
A heart attack signals loss of blood flow to the heart. Part of the heart muscle then dies. Symptoms of a heart attack may include chest discomfort, discomfort in other areas of the upper body, or shortness of breath. Other signs may include breaking out in a cold sweat, nausea, or lightheadedness. Though many people survive, a heart attack can be deadly. It is vital to get help as soon as possible for a heart attack.
If you have symptoms that you can't explain or angina that lasts more than a few minutes, call 9-1-1 or go to the emergency room right away.
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Angina Fast Facts
What is it? A heart condition occurring when the coronary arteries that bring oxygen-rich blood to the heart muscle are clogged with plaque
What are the symptoms?
What is the treatment?
- Control risk factors, including high blood pressure, cigarette smoking, high blood cholesterol levels and excess weight
- Drug treatments, such as nitroglycerin, calcium channel blockers or beta blockers
- Balloon angioplasty
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