Angina (Angina Pectoris): Causes, Symptoms, and Treatment
What is angina pectoris?
Angina pectoris, also called angina, is chest pain or discomfort that occurs when the heart muscle isn’t getting enough oxygen. It isn’t a disease itself, but a symptom of an underlying coronary artery condition. This pain typically appears during physical exertion or intense emotion, then goes away with rest. Angina is a serious warning sign that the heart isn’t receiving enough blood flow.
Causes and risk factors
Angina most often results from narrowing of the coronary arteries due to atherosclerosis, a buildup of fatty plaques on the artery walls that reduces blood flow to the heart. Several factors significantly increase this risk: smoking, high blood pressure, diabetes, high cholesterol, obesity, and a sedentary lifestyle. Family history matters too. Chronic stress, an unbalanced diet, and advanced age (especially after 45 in men and 55 in women) are additional contributing factors.
Symptoms
The signs of angina are characteristic and recognizable:
- Chest pain or pressure, often described as a tightening or squeezing sensation
- Pain radiating to the left arm, jaw, neck, or back
- Shortness of breath with exertion
- Unusual fatigue
- Nausea and dizziness
These symptoms typically occur during physical exertion, exposure to cold, or emotional stress. They generally last 2 to 15 minutes and ease with rest or after taking nitroglycerin.
Diagnosis
The doctor begins with a detailed history of the nature, duration, and circumstances of the pain. A resting and exercise electrocardiogram (EKG) is used to assess the heart’s electrical activity. Blood tests, an echocardiogram, and a myocardial perfusion scan may complete the workup. Coronary angiography, an imaging exam using contrast dye injected into the coronary arteries, is the gold-standard test for visualizing any narrowing.
Treatments
Managing angina combines medication with lifestyle changes. Prescribed medications include nitrates (to dilate the arteries during an episode), beta-blockers (to slow the heart rate), calcium channel blockers, and antiplatelet drugs to prevent blood clots. If there’s significant arterial narrowing, a procedure may be needed: coronary angioplasty with stent placement to reopen the artery, or coronary artery bypass graft (CABG) surgery to bypass blocked arteries. Cardiac rehabilitation often accompanies these treatments.
Prevention
Adopting healthy habits can significantly reduce the risk of angina and slow the progression of coronary artery disease. It’s recommended to quit smoking, engage in regular, moderate physical activity (30 minutes of walking a day), and follow a balanced diet low in saturated fat and rich in fruits and vegetables. Managing stress through relaxation techniques, maintaining a healthy weight, and regularly monitoring blood pressure and cholesterol are also essential for protecting your heart long term.
When should you see a doctor?
Angina always warrants medical evaluation. Call 911 immediately if chest pain is severe, lasts more than a few minutes, spreads to the arm or jaw, or comes with shortness of breath, sweating, or nausea, since these can signal a heart attack. See a doctor promptly if you have new chest discomfort with exertion, or if known angina becomes more frequent, more intense, or occurs at rest.
Sources
- American Heart Association, patient guidance on angina and heart disease
- Centers for Disease Control and Prevention (CDC), U.S. heart disease data and prevention
- MedlinePlus, U.S. National Library of Medicine health information