Angina: Signs, Symptoms, diagnosis and treatments

March 11, 2023

Angina: Symptoms, diagnosis and treatments

Angina pectoris, commonly known as angina, is a type of chest pain or discomfort that occurs when the heart muscle does not get enough oxygen-rich blood. It is usually caused by atherosclerosis, a buildup of plaque in the coronary arteries that supply blood to the heart muscle. The most common symptom of angina is a feeling of pressure or tightness in the chest, which may also be described as squeezing, burning, or heaviness. The arms, neck, jaw, shoulder, or back may also experience pain..

Angina can be triggered by physical exertion, emotional stress, cold weather, heavy meals, or smoking. It can also occur at rest, particularly at night. The duration and severity of angina can vary, and it may be relievedby rest or nitroglycerin, a medication that helps to widen the blood vessels and increase blood flow to the heart.

It is important to seek medical attention if you experience any symptoms of angina, as it can be a warning sign of a more serious heart condition, such as a heart attack. Your doctor can evaluate your symptoms, diagnose the underlying cause of your angina, and recommend the appropriate treatment to manage your condition and prevent complications.

Types of angina 

There are four types of angina:

Stable angina:

This is the most common type of angina and occurs when the heart is working harder than usual, such as during physical activity or stress. The pain or discomfort is usually predictable and goes away with rest or medication.

Unstable angina: 

This is a more serious type of angina that occurs suddenly and is not relieved by rest or medication. It can happen at rest, and the pain or discomfort is usually more severe and lasts longer than with stable angina. Unstable angina is a warning sign of an impending heart attack and requires immediate medical attention.

Variant angina (also known as Prinzmetal’s angina):

This is a rare type of angina that occurs when the coronary arteries spasm, causing a temporary narrowing of the blood vessels and a decrease in blood flow to the heart. The pain or discomfort is usually unpredictable and can occur at rest, during sleep, or even while taking medications to treat angina. Treatment for variant angina may include medications to prevent coronary artery spasms.

Refractory angina: 

Refractory angina occurs when the blood supply to the heart is severely restricted, often due to the narrowing or blockage of multiple coronary arteries. This can result in a significant decrease in blood flow to the heart muscle, leading to chronic chest pain and other symptoms.

It is important to know the type of angina you have, as it can affect the treatment options and management of your condition. If you experience any symptoms of angina, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment.

The symptoms of angina can vary from person to person, but typically include:

Chest pain, pressure, or discomfort: This is the most common symptom of angina and is often described as tightness, heaviness, squeezing, or burning sensation in the chest. The pain may also be felt in the arms, neck, jaw, shoulder, or back. 

Shortness of breath:

This may occur along with chest pain or as the only symptom of angina. It may feel like you cannot catch your breath or like you are suffocating.

Fatigue or weakness:This may occur along with chest pain or as a result of reduced blood flow to the heart muscle.

Nausea, vomiting, or dizziness:

These symptoms may occur along with chest pain or as a result of reduced blood flow to the brain.

Sweating:This may occur along with chest pain or as a result of the body’s response tostress.

It is important to note that not all people with angina will experience chest pain. Some may onlyexperience shortness of breath, fatigue, weakness, or other symptoms. Additionally, the symptoms of angina can be similar to other medical conditions, such as acid reflux or a panic attack, so it is important to seek medical attention to determine the underlying cause of your symptoms. If you experience any symptoms of angina, it is important to seek medical attention to receive appropriate care and prevent complications.

Angina in man or woman

Angina can occur in both men and women, but the symptoms may be different between the sexes.

Men and women can experience typical angina symptoms, such as chest pain or discomfort, but women are more likely to experience atypical symptoms that are not related to chest pain. These atypical symptoms may include shortness of breath, nausea, vomiting, back or jaw pain, fatigue, or dizziness.

Women are also more likely to have angina at a younger age than men and may have a higher risk of developing heart disease-related complications.

It is important to note that the symptoms of angina can vary from person to person, regardless of sex. If you experience any symptoms of angina, regardless of whether they are typical or atypical, it is important to seek medical attention to determine the underlying cause and receive appropriate care. Early diagnosis and treatment of angina can help to prevent complications and improve outcomes.

Causes of angina

Angina is usually caused by reduced blood flow to the heart muscle. This reduced blood flow is usually due to a narrowing or blockage of one or more coronary arteries, which supply blood and oxygen to the heart muscle. The most common cause of narrowed or blocked coronary arteries is atherosclerosis, which is a buildup of plaque in the arterial walls.

There are several risk factors that can contribute to the development of atherosclerosis and angina, including:

  • Smoking

  • High blood pressure

  • High cholesterol levels

  • Diabetes

  • Family history of heart disease

  • Lack of exercise or physical activity

  • Obesity or overweight

  • Stress or anxiety

Other less common causes of angina include:

  • Coronary artery spasm

  • Heart valve disease

  • Anemia

  • Aortic stenosis

  • Hypertrophic cardiomyopathy

  • Inflammation of the heart muscle (myocarditis)

It is important to identify and manage any underlying risk factors to prevent the development or progression of angina. If you experience any symptoms of angina or have any risk factors for heart disease, it is important to seek medical attention to determine the underlying cause and receive appropriate care.

Risk factors of angina

The following are some of the risk factors for developingangina:

Age:The risk of developing angina increases with age, especially after age 45 for men and after age 55 for women.

Gender:Men are more likely to develop angina than premenopausal women. However, after menopause, women’s risk of angina becomes similar to that of men. 

Family history: If a close family member (parent, sibling, or child) has had angina or heart disease, your risk is increased.

Smoking:Smoking cigarettes, cigars, or pipes is a significant risk factor for the development of angina and other heart diseases.

High blood pressure:

High blood pressure or hypertension can increase the risk of angina by putting extra strain on the heart and arteries.

High levels of low-density lipoprotein (LDL) cholesterol can contribute to the buildup of plaque in the arteries, leading to narrowed or blocked coronary arteries.

Diabetes:Diabetes increases the risk of developing angina due to the associated increase in blood sugar and the potential for damage to blood vessels and nerves.

Obesity or overweight: Being overweight or obese can increase the risk of developing angina and otherheart diseases by putting extra strain on the heart and increasing the likelihood of developing other risk factors such as high blood pressure and high cholesterol.

Sedentary lifestyle: 

Lack of regular exercise or physical activity can increase the risk of developing angina and other heart diseases.

Stress or anxiety:Prolonged or chronic stress and anxiety can increase the risk of developing angina by triggering an increase inblood pressure and heart rate, which can put extra strain on the heart.

It is important to identify and manage any underlying risk factors to prevent the development or progression of angina. If you have any risk factors for heart disease, it is important to seek medical attention and take appropriate steps to reduce your risk.

Complications of angina

Angina can lead to several complications, including:

Heart attack:

A heart attack occurs when a coronary artery is completely blocked, preventing blood and oxygen fromreaching the heart muscle. If angina is left untreated or is poorly managed, it can increase the risk of having aheart attack.

Arrhythmia:Angina can cause an irregular heartbeat, also known as arrhythmia. This can occur as a result of damage to the heart muscle or due to a decrease in blood flow to the heart.

Heart failure:

Chronic or poorly managed angina can lead to heart failure, a condition in which the heart is unable to pump enough blood to meet the body’s needs. This can occur due to damage to the heart muscle or a decrease in blood flow to the heart.

Sudden cardiac arrest:

In some cases, angina can lead to sudden cardiac arrest, a condition in which the heart suddenly stops beating due to a malfunction in the heart’s electrical system.

Anxiety and depression:

Chronic or poorly managed angina can also lead to anxiety and depression, which can further worsen the condition and impact overall quality of life.

It is important to seek medical attention if you experience any symptoms of angina or have any risk factors for heart disease. Early diagnosis and appropriate treatment can help to prevent complications and improve outcomes.

Prevention of angina

The following are some lifestyle changes and measures that can help prevent or reduce the risk of angina:

Quit smoking:

Smoking is a significant risk factor for angina and other heart diseases. Quitting smoking can reduce the risk of developing angina and improve overall heart health.

Manage blood pressure:

High blood pressure can increase the risk of angina and other heart diseases. Lifestyle changes such as regular exercise, healthy diet, and stress management can help to lower blood pressure.

Control cholesterol levels: High levels of cholesterol can contribute to the development of atherosclerosis,which is a major cause of angina. Eating a healthy diet, exercising regularly, and taking medications prescribedby a doctor can help control cholesterol levels.

Maintain a healthy weight: Being overweight or obese can increase the risk of angina and other heart diseases. Maintaining a healthy weight through regular exercise and a healthy diet can help to prevent or reduce the risk of angina.

Exercise regularly: Regular exercise can improve cardiovascular health, reduce the risk of angina, andimprove overall quality of life. However, it is important to consult a doctor before starting an exercise program, especially if you have any underlying health conditions.

Eat a healthy diet:

Eating a healthy diet that is low in saturated and Trans fats, cholesterol, and sodium can help to prevent or reducethe risk of angina.

Manage stress:

Chronic stress can increase the risk of angina and other heart diseases. Stress management techniques such as meditation, deep breathing, and yoga can help to reduce stress levels.

Manage diabetes:

If you have diabetes, it is important to manage your blood sugar levels to reduce the risk of developing angina and other heart diseases.

It is important to talk to a doctor about any lifestylechanges or measures that can help to prevent or reduce the risk of angina. Additionally, regular checkupsand screenings can help to identify and manage any underlying risk factors forheart disease.