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If you’ve ever felt a tightness in your chest then you know it can be an unsettling feeling. Angina, or angina pectoris, is another term for chest pain and it is one of the most common signs of coronary heart disease (CHD). When the blood isn’t flowing properly to the heart it can cause this uncomfortable and often dangerous condition. 

Angina can also occur with other symptoms such as shortness of breath, nausea, sweating, dizziness and fatigue and it is one of the most common complaints seen by healthcare workers in the ER. On top of being a sign of CHD, angina may also indicate a heart attack or a blood clot. This chest pain can be easily treated with medication that relaxes the arteries. However, if it’s more serious, it may require invasive interventions such as a stent

Keep reading to find out more about angina including its associated symptoms, causes and treatment. 

Different Types of Angina

Chest pain varies greatly in severity and the cause. For this reason, there are multiple different types of angina including stable angina, unstable angina and variant angina. 

Stable Angina

Stable angina is the most common type of angina. This type of angina is temporary and easy to treat. It can occur when the heart works harder than usual, such as during strenuous physical activity. Only usually lasting for a few minutes, stable angina typically resolves on its own.

This form of angina is often described as a pressure or tightness in the chest. According to the American Heart Association, it is sometimes also felt in the arms, neck, jaw, shoulders or back. It may be caused by narrowed or blocked coronary arteries since this reduces blood flow to the heart. 

You may hear your doctor talk about microvascular angina, which can be stable or unstable. This type of angina affects the small blood vessels of the heart. 

A stress test is a common diagnostic test that might be used in patients who have stable angina. This test involves performing physical activity while the heart is monitored, allowing your doctor to look at the effect that physical movement has on your heart. 

Unstable Angina

Unstable angina is when chest pain happens while at rest or with minimal physical activity. It is more severe and uncomfortable than stable angina and it also lasts longer. This type of angina might indicate that a heart attack could happen soon so it is important to seek medical attention right away if you are experiencing chest pain while at rest. 

This condition may be caused by a sudden change in the pattern of stable angina or if the heart is not getting enough oxygen. Unstable angina may be related to blocked arteries which require prompt medical attention. 

Cardiac catheterization is commonly used to diagnose and treat unstable angina. During this routine procedure, your doctor will insert a long, thin, flexible tube into a blood vessel to help diagnose and treat your heart condition. Cardiac catheterizations can be done while patients are fully awake, lightly sedated or under general anesthesia.  

Variant Angina

Variant angina occurs when there is a spasm in the coronary arteries, leading to a heaviness or pressure in the chest. Spasms in the coronary artery reduce blood flow to the heart, leading to chest pain. Variant angina commonly occurs at rest and the pain can last anywhere from a few minutes to half an hour. The exact cause of variant angina is unknown; it is a more rare type of angina. 

The main difference between variant angina and stable angina is that variant angina is not related to underlying coronary artery disease, while stable angina is. Doctors perform a variety of diagnostic tests to help with diagnosing and treating variant angina, such as blood tests, vital sign checks (such as heart rate and blood pressure) and in more serious cases, cardiac catheterization. 

What Are The Risk Factors

Risk factors that increase your likelihood of experiencing angina may be related to your lifestyle or your genetics. Examples of risk factors for angina include:

  • Smoking. Tobacco smoke narrows the blood vessels, including those that are responsible for bringing blood to the heart which causes chest pain. 
  • High blood pressure. Long-term effects of high blood pressure include damage to the elasticity of the arteries, which can make it harder for these vessels to deliver the necessary blood and oxygen to the heart. 
  • High cholesterol levels. High cholesterol levels often lead to a buildup of plaque in the arteries. The narrowed arteries are less able to deliver oxygen-rich blood to the heart, leading to chest pain. 
  • Obesity. Chest pain is common in individuals who are obese because of a condition called left ventricular hypertrophy. This condition is common among people who are obese and causes an imbalance in the oxygen supply and demand of the body. 
  • Lack of physical activity. Living a sedentary lifestyle in which you do not exercise or move often can cause a variety of different health conditions, including weight gain, diabetes, high cholesterol and high blood pressure. All of these conditions go hand-in-hand and can lead to chest pain. 
  • Diabetes. High blood sugar levels related to diabetes can cause damage to the blood vessels over time, leading to any number of heart conditions, including angina. 
  • Family history of heart disease. If you have a family history of angina or other heart diseases, then you are more likely to experience chest pain. 
  • Age. Chest pain is more common in older age. In men, it becomes more common after the age of 45, and in women, it becomes more common after the age of 55. 

Certain heart problems such as atherosclerosis, coronary artery disease and heart valve disease all increase a person’s risk of angina since these conditions can influence the amount of oxygen-rich blood that reaches the heart. 

Even emotional stress can make you more likely to develop heart conditions like angina. Poorly managed stress can increase your heart rate and blood pressure, placing extra stress on the heart muscle and leading to problems like chest pain. Taking steps to properly manage stress will help to increase your overall health and your heart health. 

What Are The Causes of Angina

Angina is typically caused by a narrowing or blockage of the coronary arteries, which supply blood to the heart muscle. When the heart muscle doesn’t get enough blood flow and oxygen it causes chest pain. One of the primary causes of angina is atherosclerosis, which is a buildup of plaque on the inner walls of the arteries. This buildup tends to happen when cholesterol and other fatty substances accumulate in the blood vessels over time, causing them to become narrowed and stiffened. 

Treatment for Angina

The main goal of treating angina is to reduce symptoms, prevent complications and improve overall heart health. Lifestyle changes may also be adopted to help prevent angina such as eating a healthy diet, getting exercise regularly, quitting smoking and managing stress. 

Prescription medications are commonly used to treat angina. Some examples are listed below. 

  • Nitrates are one of the most common types of medications used to treat angina, namely nitroglycerin. This medication helps to widen blood vessels to bring blood to the heart and relieve chest pain. 
  • Beta-blockers work to slow the heart rate in order to reduce the oxygen demands of the heart. 
  • Calcium channel blockers work by reducing the amount of calcium that enters the heart cells and blood vessels. This helps to relax the blood vessels of the heart to increase oxygen delivery to the heart. 
  • Aspirin works by reducing the blood’s ability to clot, helping to increase blood flow and relieve chest pain.  

In some cases, medication alone may not be enough to manage symptoms of angina and additional treatment may be needed, such as angioplasty or bypass surgery. 

Final Thoughts

Angina is an increasingly common medical condition and although many cases are easily treated, it is still a serious situation that requires prompt medical treatment. Even mild cases of angina might require medical treatment and definitely warrant further investigation to determine the cause and help with determining a plan to prevent the condition from worsening. 

Consult the cardiology experts at UCF Health for top-notch guidance on all of your heart health concerns.