Angina Pectoris

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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Angina Pectoris Overview
• Angina Pectoris Causes
• Angina Pectoris Symptoms
• When to Seek Medical Care
• Exams and Tests
• Angina Pectoris Treatment
• Self-Care at Home
• Medical Treatment
• Medications
• Surgery
• Next Steps
• Follow-up
• Prevention
• Outlook
• Support Groups and Counseling
• For More Information
• Web Links
• Synonyms and Keywords
• Authors and Editors
• Viewer Comments: Angina - How Was Diagnosis Established
• Viewer Comments: Angina - Symptoms

Angina Pectoris Overview

If you are having pain or pressure in the middle of your chest, left neck, left shoulder, or left arm, go immediately to the nearest hospital emergency department. Do not drive yourself. Call 911 for emergency transport.

Angina, or angina pectoris, is the medical term used to describe the temporary chest discomfort that occurs when the heart is not getting enough blood.

• The heart is a muscle (myocardium) and gets its blood supply from the coronary arteries.
  
  
• Blood carries the oxygen and nutrients the heart muscle needs to keep pumping.
  
  
• When the heart does not get enough blood, it can no longer function at its full capacity.
  
  
• When physical exertion, strong emotions, extreme temperatures, or eating increase the demand on the heart, a person with angina feels temporary pain, pressure, fullness, or squeezing in the center of the chest or in the neck, shoulder, jaw, upper arm, or upper back. This is angina, especially if the discomfort is relieved by removing the stressor and/or taking sublingual (under the tongue) nitroglycerin.
  
  
• The discomfort of angina is temporary, meaning a few seconds or minutes, not lasting hours or all day.

An episode of angina is not a heart attack. Having angina means you have an increased risk of having a heart attack.

• A heart attack is when the blood supply to part of the heart is cut off and that part of the muscle dies (infarction).
  
  
• Angina can be a helpful warning sign if it makes the patient seek timely medical help and avoid a heart attack.
  
  
• Prolonged or unchecked angina can lead to a heart attack or increase the risk of having a heart rhythm abnormality. Either of those could lead to sudden death.

Time is very important in angina.

• The more time the heart is deprived of adequate blood flow (ischemia), and thus oxygen, the more the heart muscle is at risk of heart attack or heart rhythm abnormalities.
  
  
• The longer the patient experiences chest pain from angina, the more the heart muscle is at risk of dying or malfunctioning.

Not all chest pain is angina. Pain in the chest can come from a number of causes, which range from not serious to very serious.

• For example, chest pain can be caused by:
  
  
  • acid reflux (gastroesophageal reflux disease, GERD),
    
    
  • upper respiratory infection,
    
    
  • asthma, or
    
    
  • sore muscles and ligaments in the chest (chest wall pain)
    
    
• If chest pain is severe and/or recurrent, the patient should see a healthcare provider.
  
  
• Go to a hospital emergency department if the patient has any of the following with chest pain:
  
  
  • Other symptoms such as:
    
    
    • sweating,
      
      
    • weakness,
      
      
    • faintness,
      
      
    • numbness or tingling, or
      
      
    • nausea
      
      
  • Pain that does not go away after a few minutes
    
    
  • Pain that is of concern in any way