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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
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 or sudden
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 the
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.
Women are somewhat more likely than men to have other symptoms like nausea and back or jaw pain.
This feeling can be in areas other than the chest, such as in the neck or jaw.
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 checked out.
Stable angina has a typical
pattern. You can likely predict when it will happen. It happens when your heart is working harder and needs more oxygen
be delivered through the narrowed arteries. Examples include when you are:
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 is a warning sign
that a heart attack may soon occur. It is an emergency. It may happen at rest or with light activity. It does not go away with rest or nitroglycerin.
Less common types of angina are caused by coronary artery spasms. This angina happens when a coronary artery suddenly contracts (spasms), reducing
oxygen-rich blood flow to the heart. 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 in their arteries. Cocaine can cause coronary
artery spasm and heart attack, but in most cases it is not known what triggers
Variant angina, also called Prinzmetal's
angina or vasospastic angina, is also caused by coronary artery spasm. But
it has a distinctive pattern. It usually occurs when you are at rest, and
there is no clear cause. It occurs more often at night, in the early morning
hours, or at the same time of the day. The spasm often occurs where plaque has narrowed the
coronary artery, but it can also occur in healthy
coronary arteries. Variant angina episodes typically last 2 to 5 minutes and
quickly subside with nitroglycerin.
Most people who have stable angina can
control their symptoms by taking medicines as prescribed and nitroglycerin
For tips on managing angina see:
Other health problems, such as fever or infection, anemia, or other heart problems, can make your angina symptoms worse. They may also cause unstable angina.
Angina may get worse when another condition:
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.
February 13, 2013
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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