Angina (angina pectoris) refers to a temporary chest pain that is caused by a lack of blood getting to the heart. Angina usually occurs when the heart has to work harder such as during exercise, after eating a big meal, going out in very hot or cold weather, or stressful situations. Angina results from the supply of oxygen, and occasionally other nutrients, being inadequate to meet the metabolic needs of the heart muscle.
The primary cause is atherosclerosis, although platelet aggregation, coronary artery spasm, non-vascular mechanisms such as hypoglycemia, and increased metabolic need (as in hyperthyroidism) can also be important. Atherosclerosis is caused by the buildup of fatty deposits within the arteries. This narrows the space through which the blood can flow. A spasm can occur at any time in some patients, even when they are at rest. This type of angina is called variant or vasospastic angina.
In most cases an attack will last for less than five minutes, but can range from less than 30 seconds to more than 30 minutes. You will learn to recognize your own pattern - that is, when attacks are likely to occur, how long they will last, and what kind of pain you will feel. If your pattern of pain changes, you should notify your doctor.
The diagnosis of angina is frequently made by history alone. Clinical evaluation of all patients with angina should include an electrocardiogram (EKG) at rest and a chest x-ray. Since more than one-half of patients with typical angina and confirmed coronary atherosclerosis have normal EKG readings at rest, diagnosis must often be confirmed using EKG stress testing or Holter monitoring.
An angina attack is not a heart attack. A heart attack is when a portion of the heart receives little or no oxygen for a longer period of time - without oxygen, that portion of the heart muscle starts to die. If angina is left untreated then a heart attack could result. Angina requires prompt attention by a doctor when the condition first develops or later, if the usual pattern of attacks changes. Be sure to contact your physician if your angina attacks begin to occur more often, are brought about by less strenuous activities than usual, last for a longer time, or feel different in any other way.
If your angina pain does not go away after you have taken three sublingual nitroglycerin tablets within ten minutes, seek emergency medical care. The symptoms of a heart attack are usually stronger than those of angina. Signs that a person is having a heart attack and should get emergency attention include: pain lasting more than 30 minutes, sweating, nausea, shortness of breath, severe anxiety, and fatigue. Most people who suffer a fatal heart attack do so because they did not get help soon enough. So, if you think you are having a heart attack, contact your doctor, call an ambulance, or get to a hospital immediately. Do not hesitate to seek help; it is always better to be safe than sorry.