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What Is Angina?

Angina is recurring pain or discomfort in the chest that happens when some part of the heart temporarily does not receive enough blood. An episode of angina is not a heart attack, and it does not mean that there is permanent or irreversible damage to the heart. It is a common symptom of coronary heart disease (CHD), which occurs when vessels that carry blood to the heart become narrowed and blocked because of atherosclerosis

Angina is usually described as a squeezing, pressure, heaviness, tightening or aching across the chest. This feeling often occurs behind the breastbone. It also sometimes occurs in the shoulders, arms, neck, jaws or back.

About 6.6 million Americans have angina, according to the American Heart Association. Many more women than men have angina. Angina is more common among African Americans than Caucasians. Mexican American males have a higher prevalence of angina than either Caucasian or black males.

People with angina may feel pain when they exercise or when they get excited emotionally. The pain usually occurs because not enough oxygen can get to the heart through the bloodstream. Other triggers for angina include eating a heavy meal, extreme heat or cold, walking into the wind, anger, alcohol and cigarette smoking.

When angina occurs, the pain is only temporary. Once the oxygen supply to the heart muscle is restored, the chest pain usually disappears. The pain does not mean that the heart muscle has suffered permanent damage. Angina seldom causes permanent damage to heart muscle.

Angina appears in two patterns: stable and unstable, according to the National Heart, Lung and Blood Institute (NHLBI). In stable angina, the pain occurs in a predictable way. Often a person recognizes that he or she is having angina only after several episodes have occurred, and a pattern has evolved. The level of activity or stress that causes the angina is predictable. Unstable angina doesn't appear gradually, but may begin as a very severe episode or as frequently recurring bouts of angina. Or, an established stable pattern of angina may change dramatically. It may begin after much less exercise than in the past, or it may appear at rest.

When someone has stable angina, an episode of angina does not mean that a heart attack is about to happen, says the NHLBI. Angina means that there is underlying coronary heart disease, and patients with angina are at an increased risk for heart attack. When the pattern of angina changes, however, the risk for an impending heart attack is much higher. Changes in angina might mean episodes become more frequent, they last longer, or they occur while the person is resting.

Two other forms of angina are recognized, according to the NHLBI. A rare form is called Prinzmetal's or variant angina. This type is caused by a spasm that narrows the coronary artery and lessens the flow of blood to the heart. The other form of angina is called microvascular angina. Patients with this condition have chest pain but have no apparent coronary artery blockages. Doctors have found that the pain results from poor function of tiny blood vessels nourishing the heart, as well as the arms and legs.

How is angina treated?
The first step in treating the coronary artery disease that causes angina is to control risk factors. These risk factors include high blood pressure, cigarette smoking, high blood cholesterol levels and excess weight.

Drug therapy is also available. Talk to your doctor to see if such therapy may be appropriate for you.

Your doctor will find the right regimen to treat your angina. He or she will take your medical history and needs into consideration.

If controlling risk factors and drug therapy do not reduce how often you have angina attacks, your doctor may recommend one of two other procedures. One is called balloon angioplasty. In this procedure, the surgeon widens narrowed arteries. The other procedure is called coronary artery bypass graft surgery. This may improve blood supply to the heart muscle.