Angina – Symptoms and Causes

Understanding Chest Pain

Chest pain due to reduced blood flow to the heart is a common condition that needs attention. There are several different forms of this chest discomfort, each with unique characteristics:

Stable Chest Pain

• Occurs mainly during physical activity
• Stops when resting or taking medications
• Typically lasts less than 5 minutes
• Shows predictable patterns (similar to previous episodes)
• May be triggered by walking uphill or cold weather

Unstable Chest Pain

• Happens unexpectedly, even at rest
• Pain worsens and occurs with less exertion
• Usually more severe than stable chest pain
• Can last 20 minutes or longer
• Doesn’t improve with rest or usual medicines
• Requires emergency treatment to prevent a heart attack

Variant Chest Pain (Prinzmetal’s)

• Not caused by artery disease, but by temporary artery spasms
• Creates sudden blood flow reduction
• Often follows regular cycles
• Usually happens at rest or during the night
• Typically responds to proper medication

Persistent Chest Pain

• Episodes happen frequently
• Continues despite multiple treatments
• Doesn’t respond well to combined medication and lifestyle changes

If you have unexplained chest discomfort, especially if it feels like pressure, heaviness, or tightness, seek medical help right away.

Many people struggle to distinguish this heart-related chest pain from other issues like heartburn, making professional evaluation crucial.

Signs and Symptoms

Heart Pain in Women

Women may experience heart pain differently than men. Their symptoms might not include the typical chest discomfort. Instead, women might notice:

• Discomfort in the neck, jaw, teeth, or back
• Nausea or stomach pain
• Breathing problems
• Sharp, stabbing pain rather than pressure in the chest

These different symptoms can sometimes cause women to delay seeking medical help, which can be dangerous in emergency situations.

When Medical Help Is Needed

Call 911 immediately if you have chest pain that:

• Continues for more than a few minutes
• Doesn’t improve with rest
• Isn’t relieved by heart pain medication

This could indicate a heart attack, and quick action is essential. Don’t drive yourself to the hospital unless absolutely necessary.

If you experience chest discomfort for the first time, see a healthcare provider to find out what’s causing it. For people with stable heart pain patterns who notice their symptoms getting worse or changing, seek immediate medical attention.

Heart pain often feels like:

• Burning sensation
• Fullness in the chest
• Pressure or squeezing

You might also feel pain spreading to your arms, neck, jaw, shoulders, or back. Other common symptoms include dizziness, tiredness, nausea, trouble breathing, and sweating.

The type and severity of heart pain can vary from person to person. Any new or changing symptoms should be evaluated by a healthcare professional right away.

Causes

Angina happens when the heart muscle doesn’t get enough blood flow and oxygen. This oxygen shortage is called ischemia.

Coronary artery disease (CAD) is the main reason for reduced blood flow to the heart. In CAD, fatty deposits called plaques build up in the coronary arteries. This narrowing of arteries is known as atherosclerosis.

Sometimes a plaque can rupture, or a blood clot can form. These events can quickly block blood flow in a narrowed artery, leading to a sudden drop in oxygen to the heart muscle.

When you’re resting, your heart needs less oxygen, so you might not feel symptoms even with narrowed arteries. But during activities that make your heart work harder, like:

• Exercise
• Emotional stress
• Cold temperatures
• Heavy meals

Your heart needs more oxygen than it can get through the narrowed arteries. The imbalance of oxygen levels leads to the onset of angina symptoms.

Risk Factors

Many factors can raise your chances of developing angina.

Age plays a significant role, with people over 60 facing higher risk. Family history is important; if your parents or siblings have heart disease, you may be more likely to develop angina.

Smoking and tobacco use damage artery linings, while secondhand smoke exposure creates similar harm. Physical inactivity leads to other problems that increase angina risk, including high cholesterol and blood pressure.

Obesity forces your heart to work harder to pump blood throughout your body, raising angina risk.

Several health conditions are linked to higher angina risk:

• Diabetes
• High blood pressure
• High cholesterol or high triglycerides
• Chronic kidney disease
• Peripheral artery disease
• Metabolic syndrome
• Previous stroke

Emotional and environmental factors can trigger angina episodes. Stress and intense emotions may cause blood pressure spikes and hormone rushes that narrow arteries. Cold temperatures can particularly trigger Prinzmetal angina, a specific type of this condition.

Some medications that tighten blood vessels, including certain migraine treatments, may trigger angina. Stimulant drugs like cocaine can cause blood vessel spasms that lead to angina episodes.

Risk Factor Category	Examples
Age & Family	Over 60 years old, family history of heart disease
Lifestyle	Tobacco use, lack of exercise, obesity
Health Conditions	Diabetes, high blood pressure, high cholesterol
External Triggers	Stress, cold temperatures, certain medications

Health Risks

Signs of Heart Attack

Chest pain from angina can limit daily activities like walking. The most serious risk is having a heart attack.

A heart attack may show these warning signs:

• Strong pressure or squeezing pain in the chest lasting longer than a few minutes
• Pain that spreads to the shoulders, arms, back, teeth, or jaw
• Passing out
• Feeling of impending doom
• More frequent chest pain episodes
• Feeling sick or throwing up
• Ongoing upper stomach pain
• Trouble breathing
• Heavy sweating

If you experience any of these symptoms, get emergency medical help right away. Quick action can save your life.

Ways to Prevent Angina

To prevent angina, make lifestyle choices that support heart health. Limit or avoid drinking alcohol. If you smoke, quit.

Choose heart-healthy foods and exercise regularly. Keep your weight in a healthy range. If you have conditions like high blood pressure or diabetes, follow your treatment plan carefully.

Find ways to reduce stress in your life. Get enough sleep—aim for 7 to 9 hours each night.

Stay up-to-date with recommended vaccines, as some illnesses can strain your heart.