Angina

What is angina?

Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually because of coronary artery disease. It is a symptom, not a disease in itself, and it signals that the heart is not getting enough oxygen at that moment.

Types of angina

• Stable angina: predictable, triggered by exertion or stress, settles with rest or medicine within minutes.

• Unstable angina: new, worsening or occurring at rest — a medical emergency that can precede a heart attack.

• Vasospastic (variant) angina: caused by spasm of a coronary artery, often at rest.

• Microvascular angina: related to the heart’s small blood vessels.

Symptoms

• Tightness, pressure or heaviness in the chest

• Discomfort spreading to the arms, neck, jaw, shoulder or back

• Breathlessness

• Symptoms that ease with rest or prescribed nitrate spray

Diagnosis

Your doctor will ask about the pattern of symptoms and may arrange an ECG, blood tests, an echocardiogram, a stress test or imaging of the coronary arteries.

Treatment

• Medicines to relieve and prevent attacks and to lower future heart risk

• Risk-factor control: blood pressure, cholesterol, diabetes, tobacco

• Angioplasty or bypass surgery for selected patients

• Cardiac rehabilitation

• EECP for selected patients with refractory angina