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Overview
What Is Angina?
Angina is temporary chest discomfort that happens when the heart muscle does not receive enough oxygen-rich blood. This reduced blood flow is often related to narrowed coronary arteries, which may limit delivery when the heart needs more oxygen. Angina is a symptom rather than a disease on its own, and it can affect people with coronary artery disease or other conditions that strain the heart. In simple terms, the angina definition is a warning sign that the heart may not be getting enough blood for its workload.
Symptoms
Angina Symptoms
Angina symptoms can vary from person to person and may differ by age, sex, and overall health. Some people describe pressure, squeezing, heaviness, or burning rather than sharp pain. Older adults and people with diabetes may have less typical symptoms, so new or unexplained symptoms should be medically assessed.
- Pressure, squeezing, fullness, or discomfort in the chest (chest pain).
- Discomfort that spreads to the arm, jaw, neck, shoulder, or back (referred pain).
- Shortness of breath (dyspnea), with or without chest discomfort.
- Sweating (diaphoresis), especially during an episode of chest discomfort.
- Nausea or an unsettled stomach during an episode.
- Dizziness or lightheadedness.
- Unusual fatigue or weakness, particularly with activity.
| Feature | Stable angina | Unstable angina |
|---|---|---|
| Typical triggers | Often follows exertion, emotional stress, cold temperatures, or a heavy meal. | May occur with little activity or at rest and may have no clear trigger. |
| Predictability | Usually follows a familiar pattern and similar level of activity. | Is new, worsening, more frequent, longer-lasting, or different from the usual pattern. |
| Response to rest or prescribed medicine | Often improves after rest or clinician-prescribed short-acting medicine. | May not improve as expected with rest or prescribed medicine. |
| Urgency | Still requires medical evaluation and an individualized treatment plan. | May signal an acute heart problem and requires immediate emergency assessment. |
Causes
Causes of Angina
Angina occurs when narrowed or restricted coronary arteries reduce the flow of oxygen-rich blood to the heart muscle. The mismatch is more likely when the heart needs extra oxygen, such as during exercise or stress. Coronary artery disease is a common underlying cause, but other conditions can also reduce oxygen delivery or increase the heart’s workload.
- Coronary artery disease can narrow the arteries that supply blood to the heart.
- Physical exertion can increase the heart’s oxygen needs and bring on stable angina.
- Emotional stress can raise heart rate and blood pressure, increasing cardiac workload.
- Cold temperatures can narrow blood vessels and make the heart work harder.
- Heavy meals can temporarily increase the body’s demands and trigger symptoms in some people.
- Anemia can reduce the amount of oxygen carried in the blood.
- Other conditions, including rapid heart rhythms or uncontrolled high blood pressure, can increase cardiac workload.
Risk Factors
Risk Factors for Angina
| Risk-factor category | Examples |
|---|---|
| Non-modifiable factors | Older age, family history of coronary artery disease, and inherited cardiovascular risk. |
| Tobacco exposure | Smoking or other tobacco use can damage blood vessels and increase cardiovascular risk. |
| Manageable medical conditions | High blood pressure, high cholesterol, diabetes, and related cardiovascular conditions. |
| Weight and activity | Obesity and physical inactivity can raise the likelihood of coronary artery disease. |
Having one or more risk factors does not confirm angina or mean that symptoms are caused by heart disease. Several manageable factors, including tobacco use, blood pressure, cholesterol, diabetes, weight, and activity level, can often be addressed with professional guidance. A clinician can help estimate individual risk and recommend appropriate changes.
Complications
Complications of Angina
- Unstable angina may develop when symptoms become new, more frequent, more severe, or occur at rest.
- A heart attack can occur when blood flow to part of the heart becomes severely blocked.
- Heart failure may develop when heart disease weakens the heart’s ability to pump effectively.
- Abnormal heart rhythms can affect how efficiently the heart pumps blood.
- Reduced activity may result when people avoid exertion because of recurring symptoms.
- Anxiety can develop when symptoms recur or feel unpredictable.
Important
Recognize changing symptoms
New, worsening, more frequent, longer-lasting, or rest-related chest discomfort may indicate an emergency. Do not rely on self-observation alone; seek urgent medical help, especially if symptoms are severe or associated with shortness of breath, fainting, sweating, nausea, or spreading pain.
Diagnosis
How Angina Is Diagnosed
Diagnosis begins with the symptom pattern, medical history, physical examination, and assessment of cardiovascular risk. A clinician will consider what brings on discomfort, how long it lasts, what relieves it, and whether the pattern is changing. Urgent chest pain may require immediate testing to look for a heart attack or another serious cause.
- An electrocardiogram records the heart’s electrical activity and may show signs of reduced blood flow or a heart attack.
- Blood tests may measure cardiac biomarkers released when heart muscle is injured.
- Stress testing assesses how the heart responds to exercise or medication that increases its workload.
- Echocardiography uses ultrasound to evaluate heart movement and pumping function.
- Coronary CT angiography creates images that can show narrowing in the coronary arteries.
- Cardiac catheterization can examine coronary blood flow directly when more detailed evaluation is appropriate.
Treatment & Management
Angina Treatment and Management
Medicines and symptom relief
- A clinician may prescribe a short-acting medicine for use during an angina episode or before an expected trigger.
- Medicines that reduce the heart’s workload or lower clot risk may help prevent episodes and cardiovascular complications.
- Cholesterol-lowering and blood-pressure medicines may slow coronary artery disease and reduce the heart’s workload.
- Related conditions, such as diabetes, anemia, or abnormal heart rhythms, should be treated as part of the overall plan.
Lifestyle changes and procedures
Long-term angina treatment may include stopping tobacco use, following a heart-healthy eating pattern, doing individualized physical activity, managing stress, and attending cardiac rehabilitation when recommended. Regular monitoring helps clinicians adjust medicines and address risk factors. Angioplasty with stenting or bypass surgery may be considered when coronary narrowing is significant or symptoms are not adequately controlled.
Prevention
Can Angina Be Prevented?
- Do not smoke, and seek support to stop using tobacco if needed.
- Work with a clinician to control blood pressure and cholesterol.
- Manage diabetes through the recommended medicines, eating pattern, activity, and monitoring plan.
- Maintain a sustainable pattern of physical activity that matches your health and fitness level.
- Choose a heart-healthy eating pattern that supports cardiovascular health.
- Take prescribed medicines as directed and discuss side effects or barriers with your clinician.
Prevention focuses on lowering cardiovascular risk and reducing the chance of coronary artery disease. These steps cannot prevent every case of angina, and they do not replace evaluation of new or recurring chest symptoms. Prompt medical advice is important even when a person is already working on prevention.
Outlook and Prognosis
Outlook and Prognosis for Angina
Many people manage stable angina over time with treatment, regular follow-up, and control of cardiovascular risk factors. The outlook varies with the severity of the underlying coronary disease, response to treatment, and other health conditions. Stable symptoms may remain predictable, but any change in pattern can signal a more serious problem.
When Should You See a Doctor
When Should You See a Doctor for Angina?
Seek emergency help
Get urgent care now
Call local emergency services immediately for new or severe chest pressure, chest discomfort at rest, symptoms lasting longer than usual, or symptoms not relieved by prescribed medicine. Emergency help is also needed for chest discomfort with shortness of breath, fainting, sweating, nausea, or pain spreading to the arm, jaw, neck, shoulder, or back.
- Arrange a prompt clinician visit for recurring discomfort brought on by exertion.
- Seek medical advice if chest symptoms become more frequent, more intense, or different from your usual pattern.
- Discuss reduced exercise tolerance or new shortness of breath with a clinician.
- Contact your care team with questions about an existing angina diagnosis or treatment plan.
Branches
1 topic
Angina
Cardiology
Symptoms
3 topics
Angina
Chest Pain
Angina
Shortness Of Breath
Angina
Sweating
