Angina (Chest Pain) – Advanced Cardio Vascular Care Center

Angina is chest pain or discomfort caused when your heart muscle doesn’t get enough oxygen-rich blood. It may feel like pressure or squeezing in your chest. The discomfort also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. But, angina is not a disease. It is a symptom of an underlying heart problem, usually coronary heart disease (CHD). This usually happens because one or more of the coronary arteries is narrowed or blocked, also called ischemia.


Types of Angina:

There are many types of angina, including microvascular angina, stable angina, unstable angina and variant angina.


Causes of Angina:

Angina is usually caused by coronary heart disease. When the arteries that supply your heart muscle with blood and oxygen become narrowed, the blood supply to your heart muscle is restricted. This can cause the symptoms of angina.


Stable Angina – where angina attacks are brought on by an obvious trigger (such as exercise) and improve with medication and rest. Stable angina isn’t life-threatening on its own. However, it’s a serious warning sign that you’re at increased risk of developing a life-threatening heart attack or stroke.


Unstable Angina – where angina attacks are more unpredictable, occurring with no obvious trigger and continuing despite resting. Some people develop unstable angina after previously having stable angina, while others experience unstable angina with no history of having angina before. Unstable angina should be regarded as a medical emergency, because it’s a sign that the function of your heart has suddenly and rapidly deteriorated, increasing your risk of having a heart attack or stroke.


Variant Angina (Prinzmetal or Coronary Artery Spasm) – This occurs at rest, when sleeping, or when exposed to cold temperatures. In these cases, the symptoms are caused by decreased blood flow to the heart’s muscle from a spasm of the coronary artery. The majority of people with this type of angina also have coronary artery disease. These spasms occur close to the blockage. Variant angina is a rare type of angina. It happens without warning. The pain is caused by sudden tightening or spasm of a coronary artery, the pain can be severe.


Microvascular Angina (Cardiac Syndrome X) – This can be a more severe type of angina that lasts longer. The pain is caused by spasms within the walls of small arterial blood vessels. This usually occurs when you’re exerting yourself, for example when you’re physically active, or have had an emotional upset. With cardiac syndrome X, your coronary arteries will appear normal when they’re investigated, and there will be no evidence of the Atheroma that usually causes angina.


Angina Symptoms Include:

Angina symptoms are often brought on by physical activity, an emotional upset, cold weather or after the meal. The main symptom of angina is chest discomfort or pain, but this sensation can vary depending on the person. Unstable angina sometimes causes sensations that feel as if you’re having a heart attack.

  • Nausea, anxiety, sweating
  • Dizziness, shortness of breath
  • Squeezing or sharp chest pains
  • Pain that radiates to your extremities or back


Risk Factors and Preventive Steps:  You can help to prevent angina caused by coronary artery disease by controlling your risk factors for clogged arteries:

  • Diabetes, obesity
  • High blood pressure
  • A family history of heart disease
  • High low-density lipoprotein (LDL) cholesterol
  • Low high-density lipoprotein (HDL) cholesterol
  • Men 45 and older and women 55 and older are more likely to experience unstable angina.


Test and Examinations to Identify Angina:

Your doctor will probably review your medical history and give you a complete physical exam. Then, he or she may want to run a few tests before recommending treatment. These tests may include:


  • Echocardiogram
  • Thallium or Cardiolite Scan
  • Electrocardiogram (ECG/ EKG)
  • Exercise electrocardiogram (Stress test)
  • Transesophageal echocardiogram (TEE)


Treatment of Angina:

Angina can be treated and managed with medicines and surgery, and by making healthier lifestyle choices. Treatment may include:

Aspirin – taken on a daily basis to help manage the condition and reduce the risk of blood clots

Nitrates – to ease the pain of an angina attack. Nitrates can be taken in many forms, including an aerosol pump spray or a tablet dissolved under the tongue. The side effects of nitrates can include flushing, headache and dizziness

Medications to lower the cholesterol level in the blood, and to lower blood pressure and slow the heart rate – which reduces how hard the heart must work

Lifestyle changes – including quitting smoking, losing excess body fat, switching to a low-fat diet and doing regular physical activity (such as walking every day)

Surgery – procedures such as angioplasty and bypass surgery are used if the angina doesn’t respond to medications and lifestyle changes.


Seek counsel from our Houston Cardiologist if you suspect you are suffering from Angina for the best treatment options for you.

Visit us at:|Call: +1 281-866-7701


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