Angina (AN-juh-nuh or an-JIE-nuh) is chest pain caused by a reduction in blood flow to the heart muscle.
Angina or angina pectoris is a type of chest pain that occurs when blood flow to the heart muscle does not meet the muscle's demand for oxygen. The heart muscle cannot survive without a consistent supply of oxygenated blood, so when the blood flow or oxygen level is lower than what the heart muscle needs, the muscle reacts by causing pain.
Some people experience angina with exercise or emotional stress. It is also commonly identified as being a side effect of abusing stimulants like cocaine. Medical problems that can cause angina to occur include the following:
The heart muscle needs a constant supply of oxygenated blood * . If this supply is insufficient in any way, the heart muscle becomes ischemic (having a reduced supply of nutrients as well as oxygen). Reductions in cardiac blood flow can occur from an obstruction in one of the vessels that supply the heart with blood; a spasm in a vessel; or a blockage or thrombus (clot).
There are three different types of angina:
The main symptom of angina is chest pain. The pain is usually associated with a predictable event, such as excessive physical activity, strong emotional arousal, eating a heavy meal, or exposure to cold. The sequence of events with angina usually is some activity; pain occurs; immediate rest; pain is relieved.
Those who experience angina describe the pain as being tight, squeezing, a heavy pressure, or a constricting sensation. It usually begins below the sternum (breastbone) and then moves or radiates to the jaw, neck, shoulder, or arm. Some people have experienced the pain of angina in the back, along with nausea and vomiting. Other symptoms that occur with the chest pain include dyspnea * , pallor, tachycardia * , anxiety, and fear.
Any type of chest pain should never be ignored. When chest pain occurs, the person should go to the nearest emergency department for evaluation and treatment. The cause of the chest pain will be analyzed; diagnosis usually includes the following types of tests:
After the diagnosis of angina is made, the health care provider will determine which class of medication to prescribe. Three major classifications of medications are used to control the pain:
Aspirin is often prescribed for individuals with angina to reduce the risk of blood clotting in the event of a myocardial infarction. The usual dosage is 75 to 81 mg to be taken every day.
The best way to prevent the development of angina is to engage in heart-healthy activities and follow a healthful diet. Regular aerobic exercise should be performed after receiving clearance from a health care provider. Exercise strengthens the heart muscle, improves blood flow, reduces blood pressure, and helps maintain a healthy body weight.
A healthful diet reduces the intake of saturated fats and limits or eliminates the intake of trans fats, while supplying the recommended amount of vitamins, minerals, and calories to achieve or maintain a healthful body weight.
Individuals identified as having elevated cholesterol or triglyceride levels should discuss medication therapy with a health care provider. Additional actions to reduce the risk of angina include stress reduction activities and smoking cessation if appropriate.
See also Anemia, Bleeding, and Clotting • Arteriosclerosis/Atherosclerosis • Heart Attack (Myocardial Infarction) • Heart Disease (Overview) • Hypertension • Thyroid Disease
Aaronson, Philip I., Jeremy P. T. Ward, and Michelle J. Connolly. The Cardiovascular System at a Glance. 4th ed. Malden, MA: Wiley-Blackwell, 2013.
Jevon, Phil. Angina and Heart Attack. New York: Oxford University Press, 2012.
Heart Foundation. “Angina.” http://www.heartfoundation.org.nz/know-the-facts/conditions/angina (accessed March 21, 2016).
National Heart, Lung, and Blood Institute. “What Is Angina?” http://www.nhlbi.nih.gov/health/health-topics/topics/angina (accessed March 21, 2016).
American College of Cardiology. Heart House, 2400 N Street NW, Washington, DC 20037. Toll-free: 800-253-4636, ext. 5603. Website: http://www.acc.org (accessed March 21, 2016).
American Heart Association. 7272 Greenville Ave., Dallas, TX 752314596. Telephone: 214-373-6300. Toll-free: 800-242-8721. Website: http://www.heart.org/HEARTORG/ (accessed March 21, 2016).
* atherosclerosis is a disease in which plaque builds up inside the blood vessels that carry oxygen-rich blood to the heart and rest of the body.
* thyrotoxicosis refers to an excessive amount of circulating thyroid hormone. It is not synonymous with hyperthyroidism, as increased levels of hormone can occur despite otherwise normal thyroid function.
* hyperthyroidism (HI-per-THY-roydih-zum) is excessive activity of the thyroid gland, characterized by an enlarged thyroid gland, increased metabolic rate, rapid heartbeat, and high blood pressure.
* anemia (uh-NEE-me-uh) is a blood condition in which there is decreased hemoglobin in the blood and usually a lower than normal number of red blood cells.
* heart failure is a condition in which a damaged heart cannot pump enough blood to meet the oxygen and nutrient demands of the body. Also called congestive heart failure.
* cardiomyopathy (KAR-dih-oh-my-OP-ah-thy) is a chronic disease of the heart muscle, in which the muscle is abnormally enlarged, thickened, and/or stiffened.
* pulmonary diseases are any abnormal condition of the respiratory system, characterized by cough, chest pain, mucus production, or harsh, vibrating, crackling, or wheezing sounds while breathing.
* oxygenated blood is blood carrying oxygen for circulation throughout the body.
* lactic acid is a compound primarily produced by muscle tissue and red blood cells as carbohydrates are metabolized when oxygen levels are low.
* anaerobic (an-air-OH-bik) metabolism extracts energy from only carbohydrate sources without the presence of oxygen to facilitate the reaction.
* aerobic (air-OH-bik) metabolism uses oxygen to extract energy from carbohydrate sources, fatty acids and amino acids
* dyspnea is difficult or labored breathing; shortness of breath.
* tachycardia is an elevated or very fast heartbeat.
* ischemic (is-KEE-mik) refers to an area or organ of the body that is lacking in adequate blood flow, often due to a tightening of or obstruction in blood vessels.
* catheter (KAH-thuh-ter) is a small plastic tube placed through a body opening into an organ (such as the bladder) or through the skin directly into a blood vessel. It is used to give fluids to or drain fluids from a person.