Hallo and welcome to Healthination. I’m dr. Holly Atkinson. Angina or angina is a term many of us
have heard before, it’s a common punch line in movies and stressful situations: "Oh my angina!" you
may hear, as someone clutches their chest. But this condition is no laughing matter. It’s common,
and it is serious.
Angina is the medical term for chest pain caused by the heart...but the sensation isn’t always
outright severe crushing pain. It can also feel like a pressure, squeezing, burning, or tightness
in the chest. The pain or discomfort usually starts behind the breastbone and sometimes feels like
indigestion. Pain can also occur in the shoulder, neck, arm, jaw, or back. Now, if you’re
experiencing new onset chest pain or if your pain isn’t going away with rest and angina medication,
call 911 or visit the emergency room immediately.
Angina occurs when the heart's oxygen demand is greater than the heart's oxygen supply. Angina is
the sign of an underlying problem, usually coronary heart disease. Coronary heart disease is when
the arteries that supply the oxygen-rich blood to the heart are narrowed, due to fatty deposits
called plaque. This blockage then prevents the normal amount of blood from reaching the heart
muscle. If coronary heart disease is left untreated, it usually goes on to cause serious
complications, like a heart attack. This is why it is so important to recognize the signs of angina
and seek medical attention if you believe you are experiencing it.
There are four major types of angina: stable, unstable, variant, and microvascular. Understanding
each type is crucial because they have different symptoms and each responds differently to
treatment. Certain types may even require emergency medical treatment.
The most common type is stable angina. This occurs when the heart is working harder than usual
because of the reduced blood flow. It typically follows a pattern and is brought on by predictable
activities, like after strenuous exercise or eating a large meal. The severity of the pain is
consistent and usually goes away after just a few minutes of rest—usually five minutes or less—or
with an angina medication.
The pain from unstable angina generally occurs more often and is more severe than stable angina. It
does not follow a pattern and can occur with or without physical exertion. If you think you’re
experiencing unstable angina, see a doctor immediately. This condition is dangerous and could be a
sign that a heart attack might occur soon.
Variant angina is rare. The pain usually occurs at rest, or at night during sleep—typically after
midnight. Since it is caused by a spasm of the muscles and the coronary artery, it responds well to
medication.
Microvascular angina is caused by damage to the smallest blood vessels in the heart. The pain may
be more severe, and last longer than the other forms of angina...as long as 30 to 60 minutes. It
may be accompanied by shortness of breath, fatigue and sleep problems. Medications may not help in
easing the pain from this type of angina.
One additional note about symptoms for women...we’re more likely to experience pain or discomfort
in areas of the body other than the chest. Women often report pain in the neck, jaw, throat,
mid-section or back. Seeing a doctor can help determine if what you are experiencing is angina and
what your next step should be.
It is also important to know that not all chest pain is angina. Other conditions can cause chest
pain along with serious complications. So, all chest pain should be checked by a doctor, just to be
sure.