When blood flow to your heart is restricted, you might feel squeezing, heaviness, tightness, pressure, or pain. This could be a symptom of coronary artery disease.
What is angina?
Angina (an-JIE-nuh or AN-juh-nuh) is chest discomfort you feel when the blood flow to your heart is cut back in some way.
The full name is angina pectoris.
The discomfort may feel like a heavy weight lying on your chest, or burning, fullness, pressure, or squeezing. Some people feel pain in their arms, neck, jaw, shoulder, or back.
Dizziness, unusual fatigue, and nausea are possible symptoms. You might also faint, have an impending sense of doom, have trouble catching your breath, or sweat more than usual.
Women are more likely than men to have symptoms other than chest pressure and may not recognize their discomfort as related to their heart.
It can be difficult to distinguish angina from other types of chest pain, such as the discomfort from indigestion.
If chest discomfort is a new symptom, seek medical care.
What causes angina?
The most likely cause is coronary artery disease (CAD), when the heart (coronary) arteries are narrowed by fatty deposits called plaques, a condition called atherosclerosis.
With one or more arteries are narrower than normal, an event like a blood clot can suddenly and severely block the flow of oxygen-carrying blood to your heart muscle. The heart needs that oxygen to function.
Exercise increases the demand for oxygen, which is why a narrowed artery may lead to angina during exertion. See this drawing illustrating the problem, from the American Heart Association.
What are the different kinds of angina?
- The most common form is stable angina. Most often symptoms appear during exercise or exertion, for example walking uphill. It usually lasts no longer than five minutes and comes predictably. Seek medical care if it arrives while at rest or lasts longer than usual.
- Unstable angina occurs at rest. Usually, the discomfort is severe and lasts for 20 minutes or longer. This is a medical emergency, as the heart may be starved for oxygen.
- Variant angina (Prinzmetal angina) occurs because of a spasm in the heart's arteries. The pain is usually intense and appears while you are at rest.
- Refractory angina is the term for angina that occurs frequently despite medication and other remedies.
What are the risk factors for angina?
Risk factors include:
- Increasing age (angina is most common in adults aged 60 and older)
- A family history of heart disease
- Smoking or exposure to secondhand smoke (which damages the lining of your arteries)
- Type 2 diabetes (this condition speeds up atherosclerosis)
- High blood pressure
- High cholesterol
- Chronic kidney disease
- A history of stroke
- Emotional stress (this causes hormonal surges that can narrow your arteries)
- Lack of exercise
- Certain medications
To protect yourself, quit smoking, avoid or limit alcohol, exercise, and maintain a healthy weight.
When to see a doctor
If your chest pain lasts longer than a few minutes and doesn't go away when you rest (or take prescribed angina medications), call 911. You may be having a heart attack, and time makes all the difference. Don’t drive yourself to the hospital unless you have no other options.
August 16, 2022
Janet O’Dell, RN