Angina is a medical term used to describe a specific type of chest discomfort caused by inadequate blood flow through the blood vessels (coronary vessels) to the heart muscle (myocardium).

This chest pain is typically occurs during physical or emotional stress, and is relieved by rest or medication (nitroglycerine tablets) within a short period of time (usually 15 minutes). Chest pain of a longer duration (more than 20 minutes) or pain appearing with a lower level of effort than before, even at rest, should be considered as potential warning signs of a heart attack or unstable angina.

Risk Factors

  • family history of heart disease

  • high blood pressure

  • high cholesterol or other types of abnormalities of cholesterol metabolism

  • diabetes

  • tobacco abuse

  • platelet polymorphism

  • homocysteine

Warning Signs 

Chest discomfort

Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.

Discomfort in other areas of the upper body

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.

Shortness of breath

This may occur with or without chest discomfort.

Other signs

These may include breaking out in a cold sweat, nausea, or lightheadedness

If you or someone you're with has chest discomfort, especially with one or more of the other signs, don't wait longer than a few minutes (no more than 5) before calling for help. Call 911 or your emergency response number. Get to a hospital right away.

Symptoms

Chest pain or angina is discomfort or pain anywhere along the front of the body between the neck and upper abdomen.

Diagnostic Tools

There are many tests to diagnose angina. Usually, more than one test is done before a definitive diagnosis can be made. These tests may include:

  • physical examination and patient history   

  • ECG

  • stress test (standard, stress echo, nuclear stress test)

  • cardiac CT angiography

  • coronary angiography  

Treatment Options

Medications for angina may include:

  • aspirin

  • beta-blockers 

  • calcium channel blockers  

  • nitroglycerin 

  • oral nitrates

  • ranolazine  

  • other medications for high cholesterol, high blood pressure, or abnormal heart rhythms.

Additional treatment may include cardiac rehabilitation.

If medications fail or in more severe cases, physicians may recommend one of the following treatment options:

  • angioplasty or stent placement (bare metal or drug eluting)coronary artery bypass grafting (CABG)

Important Instructions for Drug-Eluting Stent Patients

  • Notify your doctor immediately if you experience chest discomfort, chest pain, or shortness of breath, particularly if the symptoms are new or worsening.

  • Take your medications as prescribed by your doctor.

  • Report any side effects from your medication immediately. Side effects may include bleeding, easy bruising, nausea, vomiting, headache, or rash.

  • Do not stop any of your medications unless instructed to do so by your doctor.