Angina

About this topic

Angina happens when the heart muscle does not get the right amount of oxygen-rich blood. It is most often caused by blocked blood vessels in your heart. Angina is a sign of heart disease. Some types of angina are more severe and need more treatment than other types. ‚
There are a few types of angina: ‚

Stable angina:
- Most common type and often happens when your heart is working harder, like during exercise
- May be triggered by stress, heavy meals, smoking, or being in a very hot or very cold place
- Follows a pattern and episodes are similar. The signs most often happen again when you repeat the same activity.
- May last only a short time and is eased by rest or drugs
Unstable angina:
- Can happen at rest, during sleep, or when your heart is working a little harder
- Comes at any time and does not follow a pattern
- Lasts longer and is not often eased by rest or drugs
- Is very dangerous and needs emergency treatment
- May be the first sign of a heart attack
Variant (Prinzmetal) angina:
- Rare kind of angina and tends to happen in younger people
- May be triggered by cold weather, stress, smoking, illegal drug use, or some medications
- Often happens at night or in the early morning while resting
- Often has very bad pain that can be eased with drugs
Microvascular angina:
- May have very bad pain that lasts a longer time
- Often feel short of breath, tired, and have problems sleeping with this kind of angina
- Drugs may not help relieve this type of pain

What are the causes?

The chest pain and other signs are caused by not getting enough blood flow to the heart. The blood does not flow as well through the blood vessels that give oxygen to the heart muscle. What is limiting the blood flow to the heart may be different, based on the kind of angina. ‚

Stable angina ¢ ˆ ’ A sticky substance, called plaque, builds up inside the walls of the blood vessels of the heart.
Unstable angina ¢ ˆ ’ Blood clots partly or fully block a blood vessel.
Variant (Prinzmetal) angina angina ¢ ˆ ’ Spasms in the coronary arteries, which supply blood, flow to the heart muscle.
Microvascular angina ¢ ˆ ’ Spasms in the smallest blood vessels of the heart cause low blood flow to the heart muscle.

What can make this more likely to happen?

Those who weigh too much and those who do not exercise are also more at risk. Older age and certain other health problems like diabetes, high cholesterol, or high blood pressure may give you more change for heart disease. A family history also makes you more at risk. ‚

What are the main signs?

Chest pain that feels like pressure
Chest tightness that feels like something is squeezing your chest
Pain or pressure in your shoulders, arms, neck, jaw, or back
Women may have more pain in the upper body
May have no pain at all
Upset stomach and throwing up
Feeling tired or weak
Short of breath
More sweating
Feeling weak
Feeling dizzy
Signs often ease with rest

How does the doctor diagnose this health problem?

Your doctor will want to find out what is causing your chest pain. Your doctor will want to know if you are having a heart attack. ‚
Your doctor will do an exam. The doctor will ask if you have a family history of heart disease. The doctor will ask questions about your pain and when it happens. The doctor may order: ‚

Lab tests
Electrocardiogram
Stress test
Chest x-ray
Coronary or CT angiography
Cardiac cath

How does the doctor treat this health problem?

Treatment is based on the type of angina you have. Your doctor will use drugs, lifestyle changes, procedures, and rehab therapy to treat your signs. Your doctor will work to help you from having a heart attack. ‚

What lifestyle changes are needed?

Eat a healthy diet. Your doctor may want you to limit the amount of salt in your diet.
If you have high blood pressure, have it checked often.
If you weigh too much, talk to your doctor or dietitian about changing your diet to lose weight.
Talk with your doctor about an exercise program that is right for you.
If you are a smoker, stop smoking. Talk with your doctor if you need help with this.

What drugs may be needed?

Your doctor may start you on drugs, such as:
- Nitroglycerin patches that you will take each day
- Nitroglycerin pills to carry with you to take when you have angina
If you are to take nitroglycerin pills with angina, place one pill under your tongue and rest. If the pain has not eased in 5 minutes, take one more pill under your tongue and rest. If the pain does not ease after another 3 to 5 minutes, take a third pill under your tongue and call your local ER right away.
If nitroglycerin pills have been ordered, always carry them with you and make sure they are good. They can get out of date or spoil easily. The pill should burn or tingle when you put it under your tongue. If it does not, it may need to be replaced.
Talk with your doctor about taking an aspirin each day. Aspirin can help keep blood vessels open and avoid a heart attack.
Talk with your doctor about drugs that will help control other health problems like high blood sugar, high blood pressure, or high cholesterol.
Do not take drugs like Viagra ‚ ®, Cialis ‚ ®, Levitra ‚ ®, and some herbals if you are taking any form of nitroglycerin. They may cause your blood pressure to drop very low.
Take all drugs as ordered by your doctor. If a drug makes you sick, talk with your doctor before stopping it.

What problems could happen?

If not treated, some types of angina may lead to a heart attack or other serious heart problems. ‚

What can be done to prevent this health problem?

Eat smaller meals more often. Eat healthy meals.
Stay active. Rest often during exercise.
Keep a healthy weight.
Avoid stress.
Avoid doing things that cause your angina.
Stop smoking.

When do I need to call the doctor?

Activate the emergency medical system right away if you have signs of a heart attack. Call 911 in the United States or Canada. The sooner treatment begins, the better your chances for recovery. Call for emergency help right away if you have: ‚

Signs of heart attack:
- Chest pain
- Trouble breathing
- Fast heartbeat
- Feeling dizzy
Change in the pattern of your signs, such as pain more often, pain when at rest, pain lasts longer
Taken nitroglycerin and still have pain

Call your doctor if you have: ‚

Feeling very weak
Feelings of passing out
Very bad headache
Upset stomach or throwing up
Numbness in your arm
Swelling in your ankles that does not go away
Problems with any of the drugs you are taking
You are not feeling better in 2 to 3 days or you are feeling worse

Where can I learn more?

American Heart Association ‚
http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300287.pdf ‚
National Heart Lung and Blood Institute ‚
http://www.nhlbi.nih.gov/health/health-topics/topics/angina/ ‚
NHS Choices ‚
http://www.nhs.uk/conditions/angina/pages/introduction.aspx ‚

Last Reviewed Date

2015-01-23 ‚

List_set bdysylist

Adult
Cardiovascular

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider 's advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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