Angina

Overview

What is angina?

Angina (say: “ann-jie-na”) is a squeezing pain or a pressing feeling in the chest. It is most often caused by blockages in the arteries that supply blood to your heart. This is called coronary artery disease, or heart disease.

Symptoms

How do I know if my pain is angina?

Angina can bother you when you are doing activities like walking, climbing stairs, exercising or cleaning. The pain of angina may make you sweat or make it hard to catch your breath. You may feel pain in your arm, neck, jaw or shoulder as well as in your chest. If the pain is mild, it may go away after a minute or so of rest. If the pain is more severe, medicine may be needed. Often, a medicine called nitroglycerin is used to treat severe angina.

Some people have angina that comes on with a certain level of activity and goes away easily. They may have this kind of angina for a long time. This is called stable angina.

When the pattern of angina changes a lot, it’s called unstable angina. This is a sign of danger. More episodes of angina with less exertion, angina that comes on while you’re resting, or angina in someone who hasn’t had it before are also danger signs.

Unstable angina may be the first sign of a heart attack. If you get angina, you should call your doctor or go to the nearest emergency room right away. Another sign of danger is chest pain that doesn’t go away with rest or after taking medicine. If you have chest pain that doesn’t go away, go to the emergency room right away.

Causes & Risk Factors

What causes angina?

Angina is most often caused by blockages in the arteries that supply blood to your heart. This is called coronary artery disease, or heart disease. Your doctor will test you for heart disease and also will check for any conditions that can increase your chance of heart disease. These conditions include:

  • High blood pressure

  • Diabetes

  • Smoking

  • High cholesterol level

  • Menopause in women

  • Family members who have had heart disease at a young age

Diagnosis & Tests

What tests might my doctor do?

An electrocardiogram, sometimes called an EKG or ECG, is a simple test that can show if your heart or arteries have been damaged. If the EKG is done while you are having angina, it can also show if your pain is caused by a problem with your heart.

The next step after an EKG may be a stress test. Often, this test is done while you walk on a treadmill. Your doctor will look at how your heart handles work to see if it’s abnormal when you exercise. Your doctor may also have X-rays of your heart taken before and after you exercise. These pictures can show if an area of the heart is not getting enough blood during exercise. If this is so, it may mean that the arteries supplying blood to your heart are blocked.

Another important test is cardiac catheterization (say: “kath-a-ter-a-zay-shun”). In this test, a very long and very thin tube is inserted through an artery in the arm or leg and then guided into the heart. Dye is injected into the arteries around the heart and X-rays are taken. The X-rays will show if any of the arteries that supply the heart are blocked.

Prevention

How can I prevent angina?

The best way to prevent angina is to prevent heart disease. Keep your blood pressure, diabetes and cholesterol levels under control and, if you smoke, stop. Maintaining a healthy diet, a healthy weight and a regular exercise program can help you avoid heart disease.

If you already have heart disease, the steps listed above are important to help keep the problem from getting worse.

Treatment

How is angina treated?

If you have heart disease, your angina can be treated by treating the heart disease. If something other than heart disease is causing your chest pain, your doctor will recommend treatment for that condition.

Questions to Ask Your Doctor

  • What is the likely cause of my chest pain?

  • What lifestyle changes do I need to make at home to help relieve my symptoms?

  • Is it safe for me to exercise? How do I get started?

  • What treatment option is best for me? Will I need medicine? Surgery?

  • Will the medicine you’re prescribing interact with medicine(s) I already take?

  • What symptoms will indicate that my condition is getting worse?

  • Does angina put me at risk for any long-term problems?