Angina
Angina is chest pain caused by reduced blood flow to your heart muscle. It is a symptom of coronary artery disease (CAD), which occurs when the arteries supplying blood to the heart become blocked or narrowed.
Angina Symptoms and Diagnosis
- Angina comes and goes, usually lasting about 10 minutes or less.
- Angina may feel like pressure or a squeezing pain in your chest.
- You may also feel pain in your shoulders, arms, neck, jaw or back.
- Angina can be triggered by exercise, stress, cold weather or eating a large meal.
- The pain tends to get worse with activity and stop when you rest.
- Angina can sometimes be mistaken for indigestion.
Types of Angina
Stable Angina
- The most common form of angina, occurring when the heart is working harder than normal
- Occurs in a regular pattern
- Pain typically goes away a few minutes after you rest or take your angina medicine
- An indicator that a heart attack is more likely in the future
Unstable Angina
- Has no pattern and can take place with or without physical exertion
- Cannot be relieved by resting or taking medicine
- Occurs when narrowed arteries are further blocked by a ruptured plaque and blood clot — a warning sign for complete blockage or imminent heart attack
Variant Angina
- Fairly rare; tends to affect younger people more than stable and unstable angina
- Usually occurs at rest
- Pain can be severe but relieved by medicine
- Caused by a spasm in a coronary artery that makes the artery narrow temporarily (unrelated to atherosclerosis, or narrowing of the arteries in coronary artery disease, due to a build-up of plaque inside the arteries)
Diagnosis
To diagnose angina, your doctor will ask about your symptoms, family history and risk factors, as well as specific questions about your chest pain.
If you go to the emergency room with chest pain, tests may be ordered immediately to determine if you are having angina or a heart attack. The tests can include:
- Blood tests to check for risk factors
- Electrocardiogram (EKG or ECG)
- Holter monitor, which records your heartbeat over 24 to 48 hours
- Echocardiogram
- Stress test
- Coronary angiogram or catheterization
- CT scan
If you have a stable pattern of angina, other tests may be done to determine the severity of your disease.
Angina Treatment at BIDMC
In some cases, coronary artery disease can be managed with lifestyle changes that aim to reduce risk factors, such as:
- Quitting smoking
- Modifying your diet
- Keeping your blood pressure under control
- Exercising (check with your doctor before beginning an exercise program)
- Reducing stress
If lifestyle changes aren't enough to control your coronary artery disease, you may need medication to help your heart and arteries function better. Medications may include:
- Cholesterol-lowering drugs, or statins
- Aspirin or other blood thinner
- Beta-blockers
- Nitroglycerin
If you have a severe blockage in one or more arteries, you may benefit from angioplasty (percutaneous coronary intervention, or PCI), which can:
- Improve blood flow to your heart
- Relieve chest pain
- Possibly prevent a heart attack
Interventional Heart Care
Our expert cardiologists offer interventional care and treatment, as well as a full range of nonsurgical procedures, for angina caused by coronary artery disease.