Topic Overview

What is angina?

Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a type of chest pain or discomfort that happens when there is not enough blood flow to the heart. Angina is a symptom of heart disease that slows blood flow to the heart. This is often a result of narrowed blood vessels, usually caused by hardening of the arteries (atherosclerosis).

Angina can be dangerous. So it is important to pay attention to your symptoms, know what is typical for you, learn how to control it, and understand when you need to get treatment.

What are the symptoms?

Symptoms of angina include chest pain or pressure, or a strange feeling in the chest. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.

Other symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular heartbeat.

Know what your angina feels like and what is typical for you so you know when to call for help.

Do not wait if you think you are having a heart attack. Getting help fast can save your life. Even if you're not sure it's a heart attack, have it checked out.

What are the types of angina?

Stable angina

Stable angina has a typical pattern. You can likely predict when it will happen. It happens when your heart is working harder and needs more oxygen, such as during exercise. It also may occur during exposure to cold or during times of emotional stress. The pain goes away when you rest or take nitroglycerin. It may continue without much change for years.

Unstable angina

Unstable angina is unexpected. It is a change in your usual pattern of stable angina. It happens when blood flow to the heart is suddenly slowed by narrowed vessels or small blood clots that form in the coronary arteries. Unstable angina is a warning sign that a heart attack may soon occur. It is an emergency. It may happen at rest or with light activity. It does not go away with rest or nitroglycerin.

Angina caused by coronary artery spasms

Less common types of angina are caused by coronary artery spasms. This angina happens when a coronary artery suddenly contracts (spasms), reducing oxygen-rich blood flow to the heart. If severe, a spasm can block blood flow and cause a heart attack. Most people who have these spasms have coronary artery disease, though they don't always have plaque in their arteries. Cocaine can cause coronary artery spasm and heart attack, but in most cases it is not known what triggers the spasms.

Variant angina, also called Prinzmetal's angina or vasospastic angina, is also caused by coronary artery spasm. But it has a distinctive pattern. It usually occurs when you are at rest, and there is no clear cause. It occurs more often at night, in the early morning hours, or at the same time of the day. The spasm often occurs where plaque has narrowed the coronary artery, but it can also occur in healthy coronary arteries. Variant angina episodes typically last 2 to 5 minutes and quickly subside with nitroglycerin.

How do you manage stable angina?

Most people who have stable angina can control their symptoms by taking medicines as prescribed and nitroglycerin when needed.

For tips on managing angina see:

Quick Tips: Taking Charge of Your Angina.

Using Nitroglycerin for Angina.

What makes symptoms worse?

Other health problems, such as fever or infection, anemia, or other heart problems, can make your angina symptoms worse. They may also cause unstable angina.

Angina may get worse when another condition:

• Forces your heart to work harder, which increases the amount of oxygen it needs.
• Decreases the amount of oxygen the heart receives.

In either case, there is an imbalance between the amount of oxygen that your heart needs and the amount that it receives through the blood supply from your coronary arteries. If your heart can't get enough oxygen, your symptoms of stable angina may get worse.