All about angina

Angina is not a heart attack – but it is a warning signal.

Angina (sometimes called angina pectoris) is a squeezing, suffocating, or burning feeling in the chest. It occurs when your heart is not getting as much blood and oxygen as it needs, usually because one or more of the coronary arteries is blocked. It is not a heart attack, but rather a warning signal. People with angina may be at increased risk of a heart attack, cardiac arrest, or sudden cardiac death.

If you have chest pain, see a doctor right away – don’t assume that it is angina. But if you have been diagnosed with angina, here’s what to know.

Specific symptoms of angina include:

• Pain that starts in the centre of your chest and spreads to your left arm, neck, back, throat or jaw
• Tightness, pressure, squeezing and/or aching feeling in your chest or arm(s)
• Persistent moderate to severe indigestion
• Sharp, burning or cramping pain
• Discomfort in your neck or upper back, particularly between the shoulder blades
• Numbness or a loss of feeling in your arms, shoulders or wrists.

If you experience one or more of these symptoms for the first time, see your doctor right away. If your particular pattern of angina changes, you should also go in right away.

A warning signal
Pain is often our body’s signal that something is wrong. In the case of angina, it is the heart sending the signal that your body is working too hard for your heart to handle and that you need to slow down; stop what you are doing, and rest. It commonly occurs during physical activity, exercise, stress, during extreme cold or heat, after heavy meals, and while drinking alcohol or smoking – essentially whenever the heart is working a littler harder.

Angina is most often caused by coronary artery disease (CAD) which itself is due to atherosclerosis, or a building up of fatty deposits inside the arteries that block the flow of blood.

In some cases angina can be caused by uncontrolled high blood pressure, or other heart conditions such as an enlarged heart, or narrowing of one of the valves in the heart.

It can also be caused by coronary artery spasm, which occurs when one of the blood vessels supplying the heart muscle contracts, causing blood flowing to the part of the heart supplied by the artery to decrease or even stop. This last can result in a heart attack.

Types of angina
There are several types of angina:

Stable angina usually follows a predictable pattern and occurs when you are exercising or under emotional stress. The pain is usually relieved with rest or medication. Patients with stable angina should try to track how long it lasts and what helps ease the pain, in order to detect unstable angina if it should occur.

Unstable angina causes chest pain that is unexpected and usually happens when you are at rest. If you have chest pain that is new, worsening or constant, you have a greater risk of having a heart attack, an irregular heartbeat (arrhythmia), or sudden death. You should see your doctor or proceed to an ER right away.