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Chest Pain (Angina)

What is angina?

Angina, or angina pectoris, is the medical term for chest pain, pressure, or tightness. Angina is caused by reduced blood flow to the heart, indicating underlying coronary artery disease, or heart disease, which puts you at greater risk for a heart attack. Heart disease is caused by atherosclerosis, where fatty plaque builds up in your arteries and they get stiffer and narrower, making it more difficult for blood to flow through. Blood carries oxygen, so when blood flow to your heart is restricted, the heart muscle doesn’t get enough oxygen and this can cause chest pain (similar to a cramp).

Not all chest discomfort is angina. For example, acid reflux (heartburn) and lung infection or inflammation can also cause chest pain.

What are stable and unstable angina?

The two main types of angina are stable and unstableStable angina, sometimes called chronic stable angina, is recurrent pain or discomfort in your chest, and possibly your jaw, shoulder, back, or arm.1 It differs from unstable angina because stable angina is predictable; it is usually triggered by specific things that cause your heart muscle to need more oxygen than usual, such as physical exertion or emotional stress. Unstable angina has no recognizable pattern and can occur when a person is at rest. Stable angina generally goes away when you rest or when you take nitroglycerin, a medication that dilates (widens) your blood vessels allowing more blood and oxygen to reach your heart.

How common is stable angina?

Each year, about 400,000 new cases of stable angina are diagnosed in the US.2 More American women than men suffer from stable angina: about 3.3 million compared with 3.2 million men.3 Women who have stable angina are usually older than men with stable angina.4 Among women aged 20 or older, 3.5% of white women have stable angina, 4.7% of African-American women, and 2.2% of Mexican-American women.3 Diabetes is also more prevalent in women with stable angina compared with women with Syndrome X.5

What are Prinzmetal’s angina and Syndrome X?

Prinzmetal’s or variant angina is a form of unstable angina in which chest pain occurs at rest. The chest pain of Prinzmetal’s angina is caused by coronary artery spasm, which is an abnormal or involuntary constriction of the muscle (the spasm) in an artery of the heart. Syndrome X is a type of stable angina, which is more common in women than men. It occurs in people who have chest pain but do not show evidence of underlying heart disease, meaning that no obvious blockages in the arteries of the heart are found.

Does angina mean I’m having a heart attack?

An episode of stable angina is not a heart attack, but it does mean that you have a greater chance of having a heart attack. Angina pain means that some of the heart muscle is not getting enough blood and oxygen temporarily. A heart attack, on the other hand, occurs when the blood flow to a part of the heart is suddenly and completely cut off, usually by a blood clot. This can lead to serious heart damage.

Still, chest pain is the most common symptom of a heart attack. Here are some signs that your chest pain may not be an episode of angina and that you may be having a heart attack. If you have any of these signs, call 9-1-1 immediately:

  1. Pain or discomfort that is very bad, gets worse, and lasts longer than 20 minutes
  2. Pain or discomfort along with weakness, feeling sick to your stomach, sweating, or fainting
  3. Pain or discomfort that does not go away when you take nitroglycerin
  4. Pain or discomfort that is worse than you have ever had before

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