Angina: Overview
Angina happens when there is not enough blood flow to your heart muscle. This low blood flow is often a result of coronary artery disease. Coronary artery disease happens when fatty deposits called plaque (say "plak") build up inside your coronary arteries. This plaque may limit the amount of blood to your heart muscle. Having coronary artery disease also increases your risk of a heart attack.
Chest pain or pressure is the most common symptom of angina. But some people have other symptoms, like:
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
- Shortness of breath.
- Nausea or vomiting.
- Lightheadedness or sudden weakness.
- Fast or irregular heartbeat.
Angina can be dangerous. That's why it is important to pay attention to your symptoms. Know what is typical for you, learn how to control your symptoms, and understand when you need to get treatment.
A change in your usual pattern of symptoms is an emergency. It may mean that you are having a heart attack.
If you notice any problems or new symptoms, get medical treatment right away.
Angina
Angina happens when there is not enough blood flow to the heart muscle. This low blood flow is often a result of coronary artery disease. Coronary artery disease happens when fatty deposits called plaque (say "plak") build up inside your coronary arteries. This plaque may limit the amount of blood to your heart muscle.
Most people feel angina symptoms in their chest. The most common symptom is chest pain or pressure, or a strange feeling in the chest. But you might feel symptoms in other parts of your body. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Other symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular heartbeat.
Angina can be stable or unstable. Stable angina means that you can usually predict when your symptoms will happen. You probably know what things cause your angina. Angina may be caused by a few things, including activity, stress, smoking, and being exposed to cold. Stable angina can be relieved by rest or nitroglycerin. Unstable angina means that your symptoms have changed and are not following your typical pattern of stable angina. Unstable angina may mean that you are having a heart attack.
If you have angina, pay attention to your symptoms, know what is typical for you, learn how to control it, and understand when you need to get treatment.
Angina symptoms
Most people feel angina symptoms in the chest. The most common symptom is chest pain or pressure, or a strange feeling in the chest. But you might feel symptoms in other parts of your body. Some people feel pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Other symptoms of angina include shortness of breath, nausea or vomiting, lightheadedness or sudden weakness, or a fast or irregular heartbeat.
What are the types of angina?
The most common types of angina are stable angina and unstable angina.
Stable angina means that you can usually predict when your symptoms will happen. It happens when your heart is working harder and needs more oxygen, such as during exercise. You probably know what things cause your angina. You also know how to relieve your symptoms with rest or nitroglycerin.
Unstable angina means that your symptoms have changed from your typical pattern of stable angina. Your symptoms do not happen at a predictable time. For example, you may feel angina when you are resting. Your symptoms may not go away with rest or nitroglycerin. It is an emergency. It may mean that you are having a heart attack.
Vasospastic (also called Prinzmetal's) angina is one type of angina. It's caused by a sudden contraction, or spasm, of a coronary artery. It has a typical pattern, and symptoms go away with nitroglycerin.
How is angina treated?
Angina is treated with a heart-healthy lifestyle and medicine. You may take medicine that prevents or relieves your symptoms. You may also take other medicines to help prevent a heart attack. These include medicines to lower blood pressure and cholesterol. You may choose to have angioplasty or bypass surgery to relieve symptoms.
How is angina diagnosed?
Your doctor will ask about your medical history and do a physical exam. You may have tests to check how well your heart is working and to see if your arteries are narrowed. Examples of tests include an electrocardiogram, an echocardiogram, stress tests, and a CT angiogram.
Using nitroglycerin for angina
Your doctor will tell you when to use your nitroglycerin. You may need to take it to relieve symptoms or to prevent symptoms from happening.
Be sure to keep nitroglycerin with you at all times.
- To prevent angina, take nitroglycerin before an activity that causes angina.
If you know that some activities cause angina, try taking nitroglycerin before you do the activity. An example is walking uphill or having sex.
- To relieve angina, take one dose of nitroglycerin as soon as you feel symptoms.
If your symptoms get worse or are not getting better within 5 minutes, call 911 right away. Stay on the phone. The emergency operator will give you further instructions.
- Sit or lie down to take your nitroglycerin.
Taking nitroglycerin can lower your blood pressure, which could cause you to pass out if you are standing up. If you are driving, pull over and park the car.
- Take your nitroglycerin properly.
Nitroglycerin comes in different forms. Examples are tablets or an oral spray. Be sure to follow the instructions for your nitroglycerin. Instruction examples include:
- For under-the-tongue (sublingual) tablets, place the tablet under your tongue. Leave it there until it dissolves. If you accidentally swallow the tablet, take another. The medicine won't work if you swallow it.
- For between-cheek-and-gum (buccal) tablets, place the tablet between your cheek and gum. Leave it there until it dissolves. If you accidentally swallow the tablet, take another. The medicine won't work if you swallow it.
- For the oral spray, spray it under your tongue or on top of your tongue. Push the spray canister button and close your mouth right away.
- Store nitroglycerin correctly.
Store nitroglycerin pills in a dark-colored (such as brown), airtight, glass container that you can't see through. Keep the container tightly closed. Keep nitroglycerin pills and liquid spray away from heat or moisture. Do not open your sublingual nitroglycerin until you need a dose.
- Replace your nitroglycerin if it is past the expiration date.
Nitroglycerin can get old. And when it is old, it may not work. If your nitroglycerin supply is past its expiration date, get a new prescription as soon as you can.
- Understand nitroglycerin side effects.
You may get a headache when you use nitroglycerin. Or you may feel burning or tingling under your tongue with nitroglycerin that is used under the tongue.
Do not take an erection-enhancing medicine. These medicines include sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Combining nitroglycerin with any of these medicines can cause a life-threatening drop in blood pressure. If you have angina and have taken one of these medicines, be sure to tell your doctor so that you are not given nitroglycerin or another nitrate medicine.
How can you care for yourself when you have angina?
To manage angina, pay attention to your symptoms so you can see what causes them and what is typical for you. You may use medicine and change activities to prevent and relieve symptoms. Watch for changes in your symptoms. And know when to call your doctor or get help right away.
Modifying daily activities to manage angina
Most people who have angina can manage their symptoms. This includes knowing when to rest and taking medicine such as nitroglycerin.
You can also try modifying your daily activities to help prevent or relieve angina.
- Know when to stop and rest.
If an activity or exercise causes angina, stop and rest to relieve your symptoms.
- Be active at a lower level.
To prevent angina, try to be active at a level that does not cause symptoms.
- Warm up slowly before activity.
Warming up before you are active might prevent symptoms. If you have angina when you get up and start your daily activities, try starting slowly and easing into your day.
- Change the way you eat.
If symptoms happen after meals, give yourself time to rest and digest right after you eat. Eat smaller meals more often during the day instead of two or three large meals.
- Get help for heavy chores around the house.
Ask someone to do heavy chores for you, such as shoveling snow or mowing lawns. Maybe there is a friend, family member, or community group that can help.
If angina is more severe and you are having a hard time managing it, think about making changes in your life that might help. If it makes sense to do so, think about moving to a different home to avoid the physical stress caused by climbing stairs or doing heavy chores. If you work, think about asking for extra breaks or for tasks that allow you to sit. You can ask your doctor to write a note requesting these breaks or other adjustments so you can keep working.
Talk with your doctor if you are having a hard time managing your angina. Let your doctor know if angina is stopping you from doing daily activities or doing things that you enjoy. You and your doctor can decide whether to try other treatments.
What is angina?
Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a symptom that happens when your heart muscle does not get enough blood and oxygen. People can feel angina in different ways.
Angina can feel like:
- Chest pain or pressure, or a strange feeling in the chest.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Shortness of breath.
- Nausea or vomiting.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
What causes angina?
Angina happens when the heart muscle doesn't get enough oxygen. This most often happens because of a shortage of blood and oxygen to the heart muscle. This low blood flow is often a result of narrowed blood vessels, usually caused by hardening of the arteries (atherosclerosis).
Angina: When to call
Call 911 anytime you think you may need emergency care. For example, call if:
- You passed out (lost consciousness).
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Sweating.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
- You have angina symptoms that do not go away with rest or are not getting better within 5 minutes after you take a dose of nitroglycerin.
Call your doctor now if:
- Your angina symptoms seem worse but still follow your typical pattern. You can predict when symptoms will happen, but they may come on sooner, feel worse, or last longer.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
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