Dr. Ricardo Velazquez - Internal Medicine
Angina Pectoris ("angina") is a recurring pain or
discomfort in the chest that happens when some
part of the heart does not receive enough blood.
It is a common symptom of coronary heart disease
(CHD), which occurs when vessels that carry
blood to the heart become narrowed and blocked
due to atherosclerosis . Angina feels like a
pressing or squeezing pain, usually in the chest
under the breast bone, but sometimes in the
shoulders, arms, neck, jaws, or back. Angina is
usually precipitated by exertion. It is usually
relieved within a few minutes by resting or by taking
prescribed angina medicine.
What brings on angina?
Episodes of angina occur when the heart's need for oxygen increases beyond the oxygen available from the blood nourishing the heart. Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, alcohol, and cigarette smoking.
Does angina mean a heart attack is about to happen?
An episode of angina is not a heart attack. Angina pain means that some of the heart muscle in not getting enough blood temporarily--for example, during exercise, when the heart has to work harder. The pain does NOT mean that the heart muscle is suffering irreversible, permanent damage. Episodes of angina seldom cause permanent damage to heart muscle.
In contrast, a heart attack occurs when the blood flow to a part of the heart is suddenly and permanently cut off. This causes permanent damage to the heart muscle. Typically, the chest pain is more severe, lasts longer, and does not go away with rest or with medicine that was previously effective. It may be accompanied by indigestion, nausea, weakness, and sweating.
However, the symptoms of a heart attack are varied and may be considerably milder.
When someone has a repeating but stable pattern of angina, an episode of angina does not mean that a heart attack is about to happen. Angina means that there is underlying coronary heart disease. Patients with angina are at an increased risk of heart attack compared with those who have no symptoms of cardiovascular disease, but the episode of angina is not a signal that a heart attack is about to happen. In contrast, when the pattern of angina changes--if episodes become more frequent, last longer, or occur without exercise--the risk of heart attack in subsequent days or weeks is much higher.
A person who has angina should learn the pattern of his or her angina--what cause an angina attack, what it feels like, how long episodes usually last, and whether medication relieves the attack. If the pattern changes sharply or if the symptoms are those of a heart attack, one should get medical help immediately, perhaps best done by seeking an evaluation at a nearby hospital emergency room.
Is all chest pain "angina?"
No, not at all. Not all chest pain is from the heart, and not all pain from the heart is angina. For example, if the pain lasts for less that 30 seconds or if it goes away during a deep breath, after drinking a glass of water, or by changing position, it almost certainly is NOT angina and should not cause concern. But prolonged pain, unrelieved by rest and accompanied by other symptoms may signal a heart attack.