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3 Things to Know About Angina

August 07, 2023

You know your body needs oxygen to function, but do you know how to tell when you aren’t getting enough?

Your heart will tell you. “Angina is a chest pain or pressure, caused by the heart muscle starving for oxygen,” says Tracy Patel, MD, a cardiologist with Hartford HealthCare’s Heart & Vascular Institute.

But how can you tell if your chest pain is angina, and what can be done about it? Here’s everything you need to know.

Angina is usually caused by coronary artery disease (CAD).

CAD – a blockage or narrowing of blood vessels supplying oxygen to the heart – isn’t only the most common type of heart disease, it’s also the most common cause of angina.

“Angina is as common as coronary artery disease,” says Dr. Patel, noting that heart disease is the leading cause of death among men and women in the United States. If left unaddressed, angina can trigger life-threatening heart attacks, heart rhythm problems and heart failure.

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There are different types.

Angina can be classified as either stable or unstable, depending on its severity and predictability. Stable angina tends to last for just a few minutes and follows predictable patterns. Unstable angina causes severe symptoms that come on quickly, and require emergency medical attention.

With either type, exercise or physical activity can cause discomfort, as the heart is forced to work harder. But with unstable angina, this can be dangerous.

“Unstable angina, which can lead to a heart attack, occurs suddenly due to a blockage of the heart artery,” Dr. Patel says. “It can also occur with less and less exertion – maybe chest discomfort used to occur after walking quickly up a hill, but now occurs with daily activities around the house.”

Symptoms of unstable angina can include:

• Chest pain
• Tightness or pressure in the chest
• Fatigue
• Shortness of breath
• Excessive sweating
• Nausea or vomiting
• Feeling a sense of doom
• Pain or pressure can also spread to the neck, jaw, shoulders, arms, back or stomach

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Often, it can be managed with medication.

The good news is once it’s diagnosed, angina can be treated. To secure that diagnosis, doctors will need to look at your heart, using a:

• Stress test to see how your heart reacts to exercise
• Coronary CT scan
• Cardiac catheterization or coronary angiogram

“Discuss any chest pain with your doctors,” Dr. Patel says. “Stable angina can become unstable, which will require closer medical attention.”

Most patients will need medication, such as:

• Aspirin
• Statin or other cholesterol treatments
• Antianginals to decrease strain on the heart or improve blood flow. These include beta blockers (metoprolol or carvedilol)
• Preventive medications such as calcium channel blockers (amlodipine) or long-acting nitro (Imdur)
• “Rescue” medication (nitroglycerin) to take when experiencing pain

“Ultimately, some patients will progress to the point where they also need coronary revascularization procedures such as stenting or bypass surgery,” Dr. Patel says.