Putting It All Together: Angina

Here is a summary of the important facts and information related to angina.

  • Angina usually comes on as a feeling of pain, pressure, or tightness in the middle chest, especially behind the sternum (breastbone).
  • The sensation may spread to the left shoulder, arm, and hand, or to the neck, throat, and jaw.
  • Angina often occurs during everyday activities, such as rapid walking or running, lifting or carrying a weight, becoming angry or excited, shoveling snow, and physical stress after eating (when food is still being digested).
  • In almost all cases, the underlying cause of angina is coronary artery disease (CAD).
  • Spasm of a coronary artery can produce a condition known as variant angina pectoris (also called “Prinzmetal’s angina” or angina inversa).
  • Angina itself is not dangerous, but the narrowed coronary arteries that cause angina can increase the risk of heart attack.
  • Heart attack, in comparison to angina:
    • Occurs when there is complete or partial blockage of a coronary artery
    • Causes long-lasting chest pain (20 minutes or more) that continues even after a person rests
    • May lead to permanent heart injury or death
  • Other conditions can be confused with angina including anxiety and tension, gallbladder disease, and indigestion.
  • If one or more plaques rupture and blood clots form in a coronary artery, the condition is known as unstable angina.
  • Whether or not a person has stable or unstable angina, it is important to go to the hospital immediately if anginal pain or discomfort is:
    • More severe than previously experienced
    • Getting worse or lasting longer than 20 minutes
    • Accompanied by weakness, nausea, or fainting
    • Unchanged after taking three nitroglycerin tablets
    • Happening at an unusual time (for example, during rest)
  • The treatment of angina typically involves lifestyle changes and medication, with or without an operative procedure such as angioplasty (blood vessel repair) or coronary artery bypass surgery (surgically made arterial pathways that bypass [go around] diseased arteries in the heart).

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