Health Resource Center
Angina
Aug 20th 2008
Angina is the term generally applied to the discomfort
associated with heart disease. Although the description may be similar to
the discomfort associated with a heart attack, angina is usually transient,
lasting from as short as a few minutes up to 20 minutes although discomfort
lasting this long is more likely to be a heart attack.
COMMON DESCRIPTIONS OF ANGINA
Classically, angina
has been described as a discomfort or pain in the chest. Patients,
however, often experience many different types of symptoms and the descriptions
can include a sensation of pressure, heaviness, fullness or an ill-defined
discomfort many find difficult to describe at all. Additionally, there are
many patients in whom there is no discomfort of any type in the chest but they
will experience discomfort in other locations such as the neck, jaw, shoulder
or arm, often describing it as an “ache”, numbness or weakness. Many
patients also describe angina as the sense of heartburn and indigestion,
usually because it is located low in the center of the chest in the area
usually associated with this type of discomfort. Some will describe the
discomfort as radiating to another part of the body such as the left arm, neck,
jaw or back. Additionally, many patients may not experience discomfort at
all but will only experience a sense of breathlessness, sweating or nausea for
instance. For some, a sense of fatigue may be the only symptom.
Some studies have indicated that women in particular are more likely to
experience “atypical” symptoms but most cardiologists understand that men and
women can both experience symptoms not classically described as chest “pain”
although there are data indicating women are more likely to experience atypical
symptoms.
HOW IS ANGINA DIFFERENT FROM A HEART ATTACK?
Angina is a temporary
discomfort, although the duration of the discomfort may vary. It does not
result in damage to the heart muscle. It may also occur under various situations
such as only with exertion, in which case it is called “exert ional
angina”. If it occurs at rest it may be termed “rest angina”. As it
becomes more prolonged and more frequent it is often termed “unstable
angina”. Angina is often graded on a scale of 1 to 4 with 4 being
angina that occurs at rest. Generally, the more severe, frequent, or prolonged
your angina, the more likely it is to represent an unstable situation and a
higher probability that a heart attack is imminent. Additionally, any angina
that is experienced as a new symptom should be considered indicative of a
significant problem that needs immediate attention. Also, if there is a
change in a previously stable pattern of angina, this should also be considered
indicative of a potentially serious change and condition. This should
always be discussed immediately with your physician. If the symptoms
considered angina are not relieved, then the likelihood that an individual is
experiencing a heart attack increases significantly and immediate attention
needs to be sought. A heart attack occurs when the blood supply to the
heart muscle is so severely reduced or prolonged enough that damage to the
heart muscle occurs. The term “myocardial infarction” (MI) is
the medical term used for heart attack.
WHAT SHOULD I DO
IF I THINK I AM EXPERIENCING ANGINA OR A HEART ATTACK?
Any symptom that is
suspicious for heart disease needs to be taken seriously and evaluated and
treated quickly. Some patients with known coronary artery disease (CAD)
may experience angina occasionally and understand how to treat it with rest and
medications. Any change in the characteristics of usual symptoms of angina for
an individual, however, should raise the suspicion for progressive disease and
be discussed with the physician urgently. However, the majority of
individuals have not experienced heart disease symptoms before, or the
symptoms, even in those who experience angina occasionally, may be different
than what they are used to, usually more intense or associated with other
symptoms such as sweating or nausea. Since an individual cannot tell if
the symptoms are due to blockage that is causing damage (heart attack) or might
be temporary (angina), urgent evaluation of any suspicious symptom is
important. Immediate treatment of heart attacks is critical in minimizing the
amount of damage to the heart muscle and saving lives. Urgent evaluation
and treatment of new or progressive symptoms is necessary to avoid a heart
attack. This is best done in an emergency center without delay
