What Is Angina?

Angina is chest pain, discomfort, or pressure when an area of the heart muscle doesn’t get enough oxygen-rich blood. Angina is not a disease but a symptom of an underlying problem, such as coronary heart disease.

In the United States, one in 25 adults has been diagnosed with angina by a healthcare professional. Different medications, procedures, or lifestyle approaches can help control angina.

This article discusses the symptoms, causes, and treatment options for people with angina. 

Types of Angina

There are three main types of angina:

• Stable angina is the most common type. It happens when a person is physically active or otherwise under mental or emotional stress. It usually follows a pattern, signifying heart disease.
• Unstable angina can happen without warning, whether or not a person is physically active. This is the most severe type and can be a heart attack warning sign. It lasts longer than stable angina.
• Variant angina: This rare type of angina occurs in the early morning or at night when a person is resting. It can be a symptom of a coronary spasm, in which coronary arteries repeatedly tighten and open up.

There’s also a type of angina called microvascular angina. It’s a symptom of coronary microvascular disease (small vessel disease), which causes damage to the walls of small blood vessels that branch from the coronary arteries. Microvascular angina can occur during periods of activity or rest.

Symptoms of Angina

Most often, the warning signs of angina are chest pain or pressure. It may feel like a squeezing or burning sensation. Pain might also occur in the jaw, neck, shoulders, arms, abdomen, or back. Additionally, some individuals describe angina as feeling like indigestion.

Other symptoms of angina may include:

• Shortness of breath
• Fatigue
• Sweating
• Nausea or vomiting
• Dizziness

Causes

The leading cause of angina is reduced blood flow to the heart. Blood carries oxygen that the heart muscle needs to survive. If the heart doesn’t get enough oxygen, ischemia occurs.

 Some conditions that cause reduced blood flow include:

• Coronary heart disease
• Coronary microvascular disease
• Coronary spasm
• Heart attack

Diagnosis

To diagnose the cause of angina, healthcare providers will perform a physical exam and ask about symptoms and family history. If they suspect that an underlying heart condition could be the culprit, they may recommend various diagnostic tests, including:

• Blood tests
• Imaging procedures
• Echocardiogram (ultrasound imaging test to view the heart)
• Electrocardiogram (EKG)
• Angiography (looks at blood flow inside the body)
• Stress test

Treatment

Treatment options for angina will depend on the type and the cause. Different types of medications and/or surgery are typically part of a treatment plan.

Medication

Some medicines used to help symptoms include:

• Nitrates help blood vessels relax.
• Beta-blockers slow down the heart and reduce oxygen demand.
• ACE inhibitors lower blood pressure.
• Calcium channel blockers help relax blood vessels.
• Statins lower cholesterol.
• Clot-preventing drugs help to prevent blood clot formation.
• Ranexa (ranolazine) helps chronic, stable angina.

Surgery

Sometimes, a surgical procedure must treat the cause of angina. Options include:

• Percutaneous coronary intervention (angioplasty): A small balloon helps open an artery. Then, a stent keeps it open.
• Coronary bypass: Healthcare providers use a blood vessel or vein from somewhere else in the body to bypass a blocked heart artery. This improves blood flow to the heart.

Is Angina Serious?

Angina usually isn’t a life-threatening problem, but it can be a warning sign that a person may be at risk of having a heart attack or stroke. Most people with stable angina well managed with treatment can live a normal life. However, angina can be severe, even deadly, if it's unstable and if a heart attack is an underlying cause of it.  

Coping

Living with angina can be difficult and frustrating at times. However, if angina is well controlled with medicines and lifestyle habits, most people can lead a normal life and enjoy everyday activities. Some individuals benefit from connecting with others by joining a support group.

Summary

Angina is a symptom in which blood flow to the heart is reduced. It's often characterized by chest pain or pressure. There are different types of angina, and some are more serious than others. Healthcare providers usually treat angina with medication or surgical procedures to target the underlying condition causing the discomfort. In most cases, angina is a chronic problem that can be managed with the correct therapy.

A Word From Verywell

Angina symptoms, like chest pain, can be scary, but they should never be ignored. Stable angina is the most common type, but you'll have to see your healthcare provider to determine if you have a more serious condition, such as unstable angina. Don't wait to see your provider. It's always a good idea to get checked out immediately when dealing with undiagnosed chest pain.