Angina is pain that appears when the heart muscle is not getting as much blood as it needs in order to work as hard as it is being asked to work. Angina can be described as pain, pressure, discomfort, burning or aching. The discomfort of angina is usually felt in the middle of the chest, and sometimes it travels up to the shoulders or arms, or into the neck or jaw.
Doctors divide angina into two types:
Stable angina. This type of angina lasts just a few minutes and goes away quickly when you rest or take medication. It follows a specific pattern, tending to occur when you engage in physical activity or experience strong emotion. Exertion in cold weather or after a large meal may also bring on this type of angina.
Unstable angina. This is a far more serious type of angina. Symptoms are less predictable. The chest pain occurs at rest, during sleep, or with minimal exertion. The discomfort builds in intensity and lasts several minutes to hours. You should seek medical care immediately if this occurs, even if the chest pain goes away.
Most people who have experienced an angina attack describe it as a feeling of heaviness, pressure, or squeezing. Some people complain of a burning or aching sensation; relatively few describe the pain as sharp or stabbing. The discomfort most often feels like it’s coming from behind your breastbone. It may then spread to your shoulders, arms, neck, and jaw—even to your teeth. With angina, you may feel short of breath, and you may break out into a cold sweat. Other possible symptoms are lightheadedness and nausea.
Your doctor may suspect that you have angina based on your symptoms and your risk of coronary artery disease. He or she will review your medical history to see if you smoke (or have smoked) and whether you have diabetes or high blood pressure. Your doctor will also ask about your family's medical history and will review your cholesterol levels, including LDL (bad) and HDL (good) cholesterol.
Your blood pressure and pulse will be checked, and your doctor will listen to your heart and lungs. Your doctor will also want to perform an electrocardiogram (ECG), which records the electrical activity of the heart. It can help identify problems with heart rate and rhythm. Sometimes it can show changes indicating a blocked artery.
Many other conditions can cause chest pain. In fact, most cases of chest pain are caused by other conditions that don’t involve the heart. The features that indicate your chest pain may be angina include pain that:
• Feels like a squeezing or burning sensation, rather than sharp
• Comes on after you start exerting yourself, or when you get angry, and goes away when you rest or calm down
Both angina and a heart attack cause chest pain from the heart. With angina, the heart is temporarily not getting the blood it needs, and “screams out in pain” to alert you to slow down or calm down. The heart is not actually injured. With a heart attack, the blood supply to a part of the heart is blocked badly enough that a part of the heart muscle dies. Unlike angina, the pain of a heart attack may start at rest. Heart attack pain usually is more severe than angina, and lasts more than a few minutes. With a heart attack, in addition to the chest pain there often also is shortness of breath, sudden sweating or clammy skin, dizziness or lightheadedness, and nausea.