When your heart muscles don’t receive enough oxygen-rich blood, chest pain – or angina – is a likely result. If persistent, this pain could be a symptom of an underlying heart condition.
According to Marshfield Clinic Health System Cardiology Physician Assistant Jon-Paul Ciszewski, angina is caused by an imbalance between the supply of oxygen to the heart and the heart’s demand for oxygen. “A common cause of this would be disease affecting the coronary arteries like atherosclerosis,” he said.
Types of angina and symptoms
There are four types of angina – stable, unstable, microvascular and vasospatic or variant angina.
“Stable angina can feel like squeezing or tightness in the center or left of the chest that is caused by exertion and improves with rest. Discomfort can sometimes radiate to the jaw or arms,” Ciszewski said.
Unstable angina is caused by blood clots that block an artery and can come on as a surprise. This type of angina may get worse over time and lead to a heart attack.
“If an episode does not resolve with rest or with medications your doctor prescribes, such as sublingual nitroglycerin, then that raises concern for unstable angina and you should call 9/11,” Ciszewski said.
Microvascular angina may be a symptom of coronary microvascular disease – a disease that affects the heart’s smallest coronary artery blood vessels, according to the American Heart Association. Vasospatic or variant angina varies greatly from typical angina in that the attacks are very painful and are triggered by exertion or emotional stress when a person is at rest.
Depending on severity, angina can be treated by lifestyle changes, medication, angioplasty or surgery.
“It is important to report symptoms to your medical providers so it can be determined if they are in fact heart related,” Ciszewski said. “If symptoms like chest pressure are in fact heart related, then medications and procedures can be pursued to relieve symptoms.”
Once the cause of angina is determined, a course of treatment is determined. Treatments can help reduce angina pain and lower the risk for heart attack.
Leaving angina untreated is not a wise choice. “Angina is a symptom of underlying cardiac disease. If left untreated you could be at risk for a heart attack or other health issues,” Ciszewski said.
Angina risk factors
Angina often is a sign of underlying coronary artery disease (CAD). A strong family history of CAD, aging, diabetes, smoking, hypertension, high cholesterol and obesity could put you at risk for angina.
Maintaining a healthy diet, exercising regularly and keeping tabs on any additional risk factors are key.
If you are having persistent chest pain, talk with your primary care provider.