What is angina and how is it treated?

Posted March 22, 2021 by Justin M Dunn, MD

In times of intense stress, does it ever feel like someone is squeezing your heart? Do you feel pain or numbness down your left arm? Does it seem like you get indigestion each time you exercise?

If you answered yes to any of these questions, you may be suffering from angina. Angina occurs when the heart muscle does not receive enough oxygen-rich blood. The pain can be mild or severe and often follows exertion or stress.

Angina is not a disease, but instead a symptom of a more serious heart condition called coronary artery disease.  The coronary arteries supply blood to the heart muscle itself.  Most patients who experience angina do so because of plaque buildup in one or more coronary arteries that slowly and steadily constrict blood flow to the heart. If the artery becomes completely blocked, a heart attack will occur.

There are two main types of angina:

Stable angina is the most common and has a predictable pattern that patients recognize. Symptoms are typically triggered by certain situations, such as exercising, emotional stress or eating large meals. They usually last around 10 minutes, but no longer than 20 minutes, and resolve after rest or taking medication.

Unstable angina has an unpredictable pattern that is constantly changing or rapidly getting worse. Symptoms tend to come on more frequently with less exertion, sometimes with little to no stress or activity. The symptoms may be more severe and last longer, and may not be relieved with rest or taking medication. Because unstable angina can be a precursor to a heart attack, emergency treatment is required.

Risk factors for angina

Angina becomes more common as people age. Men over the age of 45 and women over age 55 are at a greater risk for the condition.

Other risk factors for angina include:

Family history of heart disease

High blood pressure

High cholesterol

Diabetes

Obesity

Smoking

Stress

Symptoms of angina

Angina manifests in people differently. However, common manifestations of angina include:

Chest pain or tightness

Pressure, squeezing or burning in the chest

Shortness of breath

Lightheadedness

Fatigue

Nausea and diaphoresis (sweats)

Numbness or tingling in the shoulders, arms or wrists

Discomfort that spreads to other areas, such as the shoulders, jaw, between the shoulder blades or down your arm

If you experience angina symptoms for more than 20 minutes and rest or taking medication doesn’t relieve them, it may mean you’re having a heart attack and you could have permanent heart damage. Call 9-1-1 for immediate medical attention.

If you think you may be experiencing angina, take note of your symptoms to look for repeating patterns and contact your doctor. Keep track of triggers (exercise, stress, eating) that lead to the onset of angina symptoms--where you feel pain, how long your symptoms last and what relieves them. Keeping track of your symptoms and patterns can help with a diagnosis.

Diagnosis and treatment of angina

To diagnose angina, your doctor will perform a physical exam and likely order a combination of tests, such as a blood test, ECG (electrocardiogram) and stress test, among others.

Treatment for angina depends on how blocked an artery has become. With mild angina, usually medicine and lifestyle changes can control your symptoms. If it’s more severe, you may need a heart catheterization and the placement of a stent or even open heart surgery for partially or totally blocked arteries.

Your doctor also will discuss lifestyle changes to reduce your chance of angina attacks. Eating a heart-healthy diet, getting daily exercise and quitting smoking all can help to reduce your risk. Practicing stress-management techniques and avoiding strenuous activities also can help.

Consider angina a warning sign and make healthier choices to protect your heart.

If you answered yes to any of these questions, you may be suffering from angina. Angina occurs when the heart muscle does not receive enough oxygen-rich blood. The pain can be mild or severe and often follows exertion or stress.

Angina is not a disease, but instead a symptom of a more serious heart condition called coronary artery disease.  The coronary arteries supply blood to the heart muscle itself.  Most patients who experience angina do so because of plaque buildup in one or more coronary arteries that slowly and steadily constrict blood flow to the heart. If the artery becomes completely blocked, a heart attack will occur.

There are two main types of angina:

In times of intense stress, does it ever feel like someone is squeezing your heart? Do you feel pain or numbness down your left arm? Does it seem like you get indigestion each time you exercise?

Stable angina is the most common and has a predictable pattern that patients recognize. Symptoms are typically triggered by certain situations, such as exercising, emotional stress or eating large meals. They usually last around 10 minutes, but no longer than 20 minutes, and resolve after rest or taking medication.

Unstable angina has an unpredictable pattern that is constantly changing or rapidly getting worse. Symptoms tend to come on more frequently with less exertion, sometimes with little to no stress or activity. The symptoms may be more severe and last longer, and may not be relieved with rest or taking medication. Because unstable angina can be a precursor to a heart attack, emergency treatment is required.

Risk factors for angina

Angina becomes more common as people age. Men over the age of 45 and women over age 55 are at a greater risk for the condition.

Other risk factors for angina include:

Family history of heart disease

High blood pressure

High cholesterol

Diabetes

Obesity

Smoking

Stress

Symptoms of angina

Angina manifests in people differently. However, common manifestations of angina include:

Chest pain or tightness

Pressure, squeezing or burning in the chest

Shortness of breath

Lightheadedness

Fatigue

Nausea and diaphoresis (sweats)

Numbness or tingling in the shoulders, arms or wrists

Discomfort that spreads to other areas, such as the shoulders, jaw, between the shoulder blades or down your arm

If you experience angina symptoms for more than 20 minutes and rest or taking medication doesn’t relieve them, it may mean you’re having a heart attack and you could have permanent heart damage. Call 9-1-1 for immediate medical attention.

If you think you may be experiencing angina, take note of your symptoms to look for repeating patterns and contact your doctor. Keep track of triggers (exercise, stress, eating) that lead to the onset of angina symptoms--where you feel pain, how long your symptoms last and what relieves them. Keeping track of your symptoms and patterns can help with a diagnosis.

Diagnosis and treatment of angina

To diagnose angina, your doctor will perform a physical exam and likely order a combination of tests, such as a blood test, ECG (electrocardiogram) and stress test, among others.

Treatment for angina depends on how blocked an artery has become. With mild angina, usually medicine and lifestyle changes can control your symptoms. If it’s more severe, you may need a heart catheterization and the placement of a stent or even open heart surgery for partially or totally blocked arteries.

Your doctor also will discuss lifestyle changes to reduce your chance of angina attacks. Eating a heart-healthy diet, getting daily exercise and quitting smoking all can help to reduce your risk. Practicing stress-management techniques and avoiding strenuous activities also can help.

Consider angina a warning sign and make healthier choices to protect your heart.

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