Angina pectoris
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Angina pectoris is severe pain, sometimes described as crushing, which is manifested as a pressure or suffocating feeling just behind the breastbone. This pressure is caused by a lack of oxygen to the heart and is the result of coronary heart disease. Over time, one or more of the arteries leading to the heart becomes narrowed or blocked, causing ischemia, or insufficient blood supply. This condition is also simply called angina. More than nine million people in the United States suffer from angina pectoris.


Angina pectoris is typically experienced in the symptoms of uncomfortable pressure, which feels like squeezing or pain in the center of the chest. You may also feel it in the neck, jaw, shoulder, back, arm, or stomach, including nausea. It has been described as a tight or heavy feeling in the chest, or sometimes as pressure, squeezing, or burning. It can feel very difficult to breath, as though you are short of breath and unable to fill your lungs completely. These symptoms can be accompanied by numbness or tingling in the shoulders, arms, or wrists. However, just because you have these symptoms does not mean you have angina. You could have pericarditis, the inflammation of the sac around the heart. It might be something very serious, such as an aortic dissection, in which the inner layers of the aorta separate, causing you pain. It might be a coronary spasm, in which the blood vessels to the heart spasm and constrict the blood flow momentarily. You may even be having a heart attack, so these painful symptoms should be evaluated by your doctor immediately. Even some non-heart related conditions can cause angina, such as heartburn, panic attacks, pleurisy (an inflammation of the chest membrane), esophageal spasms (in which the esophagus spasms causing food to back up), or simple sort muscles from improper stretching, or from conditions such as fibromyalgia. You may also have a lung infection or inflammation.


Angina, the feeling of pain or pressure, occurs when the heart needs more blood to bring it oxygen, so strenuous activity might trigger it. Running or walking quickly, carrying groceries, a rush of strong emotions, lifting something heavy, eating too much, having sex, or even extremes in temperatures, might trigger an attack. In some people, angina is caused by a condition known as coronary artery spasm, and in those cases you might feel pain or pressure even when you are resting.

There are two different types of angina pectoris. There’s stable angina, and in these cases, the angina is usually predictable and you can expect to have symptoms in consistent situations (every time you run, every time you get angry, etc). Unstable angina means that the pain takes you by surprise, and can occur when you are at rest. With unstable angina, the chest pain can be more severe and prolonged than with stable angina. Both of these conditions can be caused by reduced blood flow to the heart muscles because of blockage by fatty build-ups. This blockage is called arterioschlerosis.
angina pectoris
Image: Angina Pectoris


Angina is a serious sign that someone is at high risk for a heart attack, which can lead to cardiac arrest and death. If you have episodes of chest pain or pressure, you should see your doctor for an evaluation as soon as possible; it might be an indicator of a very serious condition. This is true especially for those with unstable angina; a new or unexpected pain should be treated as an emergency.

The doctor will take a medical history and evaluate your risk factors, then will give you a physical exam. They will also order a blood test and chest X-ray and take an ECG, or electrocardiogram. Some people will be required to take a stress test to discern how the heart acts under exertion. Other treatments might include putting in a heart catheter or doing a coronary angiogram.


People with angina are at increased risk for heart attacks, arrhythmias (heartbeat irregularities), and cardiac arrest, which is the stopping of the heart leading to death. Again, it is important to stress that angina is a sign of heart disease. But heart disease can be treated in several different ways. Your doctor might prescribe nitroglycerin. This medication comes in small tablets that you put under your tongue to dissolve. Nitroglycerin can also be taken as a spray, capsule, skin patches, or ointment. It is not habit-forming. If the blockage of the arteries that causes the angina is very serious, you might also have to undergo angioplasty, in which a tiny balloon is inserted into the blocked arteries and the plaque is pressed backward, allowing more room for blood to flow to the heart. Another possible surgery is coronary bypass, in which blood vessels are rerouted to bypass a blocked artery, in order to get blood more easily to the heart.

Unlike some diseases, however, angina can be stopped before it even gets started. It is quite preventable, but even if you haven’t prevented it, you can reduce it through some basic lifestyle changes. First, stop smoking. Smokers have more than double the risk of heart attacks and strokes than non-smokers, and heavy smokers have more than twice the risk of light smokers. Adopt healthier eating habits; avoid trans fats, saturated fats, cholesterol, and salt. A healthier diet will also help you control your blood pressure and overall cholesterol levels. Another overlooked lifestyle change concerns stress; can you relax, even when life is challenging? Learn to breathe deeply to keep oxygen flowing, which is necessary both to your heart and your feeling of well-being.


While it’s true that making good lifestyle choices can go far in preventing the heart disease that angina signals, it’s also true that some people are just prone to it because of their family history. Make sure to tell your doctor if anyone in your family has had heart disease, or a heart attack or stroke. This information will help your doctor decide when and how to treat your angina.
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