Angina is discomfort or pain in the chest due to an insufficient amount of oxygen-rich blood getting to the heart. Chest pain due to angina can radiate to the shoulders, arms, neck, or jaw. Angina symptoms can be atypical in some patients, particularly in women and in patients with diabetes. In some cases, angina symptoms can include shortness of breath, nausea or upper abdominal pain.
Although not all chest pain is related to heart disease, angina-type chest pain can be a symptom of an underlying heart condition such as coronary artery disease. In this case, a blockage or narrowing of one or more of the coronary arteries obstructs blood flow sufficiently to cause a symptom (chest pain). Sometimes, angina occurs due to coronary microvascular disease (MVD), which affects the smaller coronary arteries in the heart. Angina due to MVD is more prevalent in women.
Recognizing angina early and seeking treatment can reduce symptoms and avert more serious consequences of untreated heart disease.
Types of Angina
There are multiple types of angina:
- Stable angina (angina pectoris): Pain that follows a predictable pattern, typically occurring with exertion/cardiovascular effort. This is the most common form of angina.
- Unstable (progressive) angina: Pain that is increasing in frequency or severity. Chest pain of this type is more concerning for an impending heart attack.
- Variant (prinzmetal) angina: Pain that can occur at rest and in younger patients. It can be triggered by physical exertion or stress and is thought to be due to spasm of the artery.
- Microvascular angina: Pain caused by abnormal function of the tiny (microscopic) arteries of the heart.
Angina Risk Factors
Major risk factors for angina due to coronary artery disease include:
- Unhealthy cholesterol levels
- High blood pressure
- Metabolic syndrome
- Inactive lifestyle
- Unhealthy diet
- Age (45+ years for men and 55+ years for women)
- Family history of heart disease at an early age
If you have any type of chest pain, you should seek medical attention. If your healthcare provider suspects you are experiencing angina due to a heart condition, several tests and/or procedures may be recommended, including:
- Coronary angiography (cardiac catheterization)
- Computed tomography angiography
- Stress test
- Chest X-ray
- Blood test
The goal of evaluating a patient with chest pain thought to be caused by angina is to:
- Rule out an immediate life-threatening condition
- Determine the appropriate follow-up testing for further evaluation and to guide treatment
- Recommend treatment of the underlying cardiovascular condition and improve symptoms
Treatment recommendations for angina might include:
- Improving blood flow to the heart with medications, stents or bypass surgery.
- Medications to reduce the progression of coronary artery disease.
- Medications to reduce symptoms of angina.
- Changes in lifestyle.
- Improved control of risk factors such as diabetes, high blood pressure or tobacco use.
- Cardiac rehabilitation.
Seek immediate medical attention if your symptoms are new or alarming.
Make an Appointment
To schedule an appointment to discuss your need for angina treatment, call us at 888-287-1082 or visit our Make a Cardiovascular Appointment page, where you may fill out a Patient Appointment Request Form and view other information about scheduling a cardiovascular appointment.