Angina or angina pectoris (Latin for squeezing of the chest) is not a disease in itself. It’s the primary symptom of coronary artery disease (CAD). It can be a warning sign of a heart attack and usually indicates a partial blockage in the blood flow to the heart. A less common cause of angina is spasm of the coronary arteries.
Angina is more common and more intense in men than in women. Doctors are uncertain if this is because women tolerate pain better than men do or whether women unconsciously lower their physical activity to avoid attacks of angina. Angina attacks in men usually occur after the age of 30 while in women they typically occur later in life.
Angina is usually felt as pressure, heaviness, tightening, squeezing, or aching across the chest, particularly behind the breastbone. This pain often radiates to the neck, jaw, arms, back, or even the teeth. You may also experience indigestion, heartburn, weakness, sweating, nausea, cramping and shortness of breath.
Angina typically occurs during exertion, severe emotional stress or after a heavy meal, as that is when the heart muscle demands more blood oxygen than the narrowed coronary arteries can supply.
Angina is classified as either stable or unstable.
Stable angina is the most common type of angina. Symptoms are somewhat predictable (e.g. walking up a flight of steps causes chest pain), usually last less than five minutes, get better with rest or medication (such as placing a nitroglycerine tablet under the tongue to relax the blood vessels and lower blood pressure) and feels like indigestion.
Symptoms may include pain that is more severe and lasts longer than stable angina. This type of angina may last up to 30 minutes, may not be relieved with rest or medication and could signal a heart attack.
Up to 25% of people with significant coronary artery disease have no symptoms at all, even though they clearly lack adequate blood and oxygen supply to the heart muscle. These patients have “silent” angina and have the same risk of a heart attack as those with symptoms of angina.
Apart from rest and medications (nitroglycerine, beta blockers, calcium channel blockers), treatment also includes angioplasty and/or bypass surgery.