What is angina?

Angina is commonly described as chest pain or discomfort that happens when your heart doesn't get enough oxygen-rich blood. It may feel like tightness, pressure, squeezing, or pain in your chest. You may also feel discomfort in your shoulders, arms, back, neck, and jaw. Angina can sometimes feel like indigestion. Other symptoms of angina include nausea, tiredness, shortness of breath, sweating, and dizziness.

The two most common types of angina are called stable and unstable. Stable angina happens when the heart is working harder than usual and usually goes away with rest. The pain has a regular pattern, lasts 5 minutes or less, and comes and goes at expected times, such as during exercise. Unstable angina doesn't have a pattern and happens more often. It's usually more uncomfortable and lasts longer than stable angina. This type of angina may signal a heart attack and requires emergency treatment.

What causes angina?

Angina happens when the vessels that supply blood to your heart become narrow or blocked. It's usually a symptom of coronary artery disease, which occurs when a waxy substance called plaque builds up in those arteries. They become narrow, slowing or stopping blood flow and causing discomfort.

Some risk factors can increase your chances of getting coronary artery disease and angina. These include smoking, diabetes, high blood pressure, high "bad" cholesterol or triglyceride levels, a family history of heart disease, lack of exercise, obesity, and stress. Your risk also goes up if you're a man over age 45 or a woman over age 55.

How will my healthcare provider help me?

Your healthcare provider will ask you questions about your health history and your angina symptoms. You'll be asked to describe your discomfort and about what triggers the discomfort, how long it lasts, and what makes it go away.

Your healthcare provider may order one of these tests to confirm if you have angina.

* An ECG. This test records your heart's electrical activity. It can help your healthcare provider see any problems in the blood flow to your heart.

* A stress test. During the stress test, you'll walk on a treadmill, pedal a stationary bicycle, or receive a medicine. Your blood pressure and ECG will be watched closely. This test shows how your heart responds to exercise.

* An echocardiogram. This test, which uses sound waves to make images of the heart, can show parts of your heart that aren't getting enough blood.

Other tests include chest X-rays, blood tests, cardiac computed tomography, or magnetic resonance imaging.

How is angina treated?

Making some lifestyle changes can help.

* If you smoke, stop.

* If you're overweight, talk to your healthcare provider about losing weight.

* Increase your physical activity. Ask your healthcare provider about the kinds of activities that are safe for you.

* Eat a healthy, low-fat diet. Include lots of whole grains, fruits, and vegetables.

* If you have diabetes, keep your blood sugar under control.

* Avoid eating large meals that make you feel stuffed.

* Find ways to relax and manage stress.

Your healthcare provider may prescribe medicines to help increase blood flow to your heart, including nitroglycerin.

Your healthcare provider may also recommend taking a daily low-dose aspirin to help prevent blood clots that can block blood vessels.

If lifestyle changes and medicine don't help your angina, your healthcare provider may suggest a medical procedure such as angioplasty, where a small balloon is inserted into your heart's blood vessels to open them. A stent may be used to help keep the blood vessels open. Or you may need a coronary artery bypass surgery. During this surgery, one or more veins or arteries from somewhere else in your body, or synthetic ones, are used to bypass a blocked or narrowed artery.