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Angina Symptoms – Causes and Treatment

Angina symptoms typically include chest pain, pressure, and tightness caused by reduced blood flow to the heart muscle during physical or emotional stress.

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Things worth knowing about "angina symptoms"

Angina symptoms typically include chest pain, pressure, and tightness caused by reduced blood flow to the heart muscle during physical or emotional stress.

What is Angina Pectoris?

Angina pectoris is not a disease in itself but a set of symptoms caused by a temporary reduction in blood supply to the heart muscle. The term derives from Latin and roughly translates to tightness of the chest. Symptoms occur when the heart does not receive sufficient oxygen-rich blood, most often triggered by physical exertion or emotional stress.

Common Symptoms of Angina

Angina symptoms can vary from person to person. The most frequently reported include:

Pressure or tightness in the chest: Many patients describe a sensation as if a heavy weight is pressing on the chest.
Chest pain: The pain may be dull, burning, or cramping and is typically felt behind the breastbone.
Radiating pain: Pain may spread to the left arm, shoulders, neck, jaw, or back.
Shortness of breath: Breathlessness, especially during physical activity, is a common accompanying symptom.
Dizziness and nausea: Some individuals also experience dizziness, nausea, or sweating.
Fatigue and general discomfort: Particularly in women, fatigue and a general feeling of being unwell may be the predominant symptoms.

Stable vs. Unstable Angina: Differences in Symptoms

Stable Angina

Stable angina symptoms are predictable, typically occurring with physical exertion or stress and resolving within a few minutes of rest or after taking nitroglycerin. The intensity and duration remain relatively consistent.

Unstable Angina

Unstable angina is more dangerous and constitutes a medical emergency. Symptoms occur even at rest, are more severe, and last longer. They may indicate an impending heart attack and require immediate medical attention.

Variant Angina (Prinzmetal Angina)

This rare form occurs mainly at night or at rest and is caused by spasms of the coronary arteries. Symptoms can resemble those of a heart attack.

Causes of Angina Symptoms

The most common underlying cause is coronary artery disease (CAD), in which fatty deposits (plaques) build up inside the coronary arteries, restricting blood flow. Other contributing factors include:

High blood pressure (hypertension)
Diabetes mellitus
Elevated blood lipids (hyperlipidemia)
Smoking and obesity
Coronary artery spasms

Diagnosis

Several diagnostic tests are used to evaluate angina symptoms:

ECG (Electrocardiogram): Measures the electrical activity of the heart at rest and under stress.
Stress test: Assesses cardiac function during physical exertion.
Blood tests: Cardiac markers such as troponin are measured to rule out a heart attack.
Coronary angiography: Imaging of the coronary arteries to identify blockages.
Echocardiography: Ultrasound examination of the heart structure and function.

Treatment

Treatment depends on the underlying cause and severity of symptoms. Options include:

Medications: Nitrates for acute symptom relief, beta-blockers, calcium channel blockers, and antiplatelet agents such as aspirin.
Lifestyle changes: Quitting smoking, adopting a heart-healthy diet, regular physical activity, and stress management.
Interventional procedures: Balloon angioplasty (PTCA) with stent placement to widen narrowed arteries.
Bypass surgery: In cases of severe coronary artery disease, surgical intervention may be required.

When to Seek Medical Help

Anyone experiencing chest pain or pressure for the first time should see a doctor promptly. If symptoms occur at rest, increase in intensity, or do not improve within 5 to 10 minutes, emergency services should be called immediately, as a heart attack cannot be ruled out without medical evaluation.

References

World Health Organization (WHO): Cardiovascular Diseases – Fact Sheet. Geneva, 2023. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
American Heart Association (AHA): Angina Pectoris – Symptoms and Causes. Dallas, 2022. https://www.heart.org
Kasper DL et al.: Harrison's Principles of Internal Medicine. 21st edition. McGraw-Hill, New York, 2022.

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