What is angina pectoris?
By Nancy Kupka, PhD, RN Mar 31, 2020 • 4 min
Blood carries oxygen and nutrients necessary for your heart to work properly.
Angina pectoris—"angina" for short—is chest discomfort likely caused by diminished blood flow and, therefore, diminished oxygen to your heart.
Plaque, a fatty material that builds up inside one or more of the arteries that carry blood to your heart, causes a partial or complete blockage of the blood flow. (Think about a garden hose that has a lot of scaly buildup inside of it, which restricts the flow of water.) This plaque buildup, called atherosclerosis, interferes with the flow of blood to your heart over time.
Symptoms and types
Angina pectoris symptoms can be obvious or subtle. It causes chest pain in the form of heaviness, tightness, pressure, aching, burning, numbness, fullness or squeezing. It may also feel like heartburn or indigestion, and any form of angina discomfort may be constant or come and go. The chest discomfort may be accompanied by shortness of breath with minimal exertion (such as walking across a room), nausea, sweating or fatigue.
There are several types of angina, and the signs and symptoms depend on which type you have. The types of angina are stable, unstable, microvascular and variant.
- Stable angina usually follows a pattern, such as discomfort occurring after exercise or when you are under stress. The pain usually goes away after you rest or take angina medicine. If these symptoms occur for at least two months, you may have stable angina.
- Unstable angina, also referred to as acute coronary syndrome, usually lasts longer than five minutes and may occur with or without physical exertion, and rest or medication may not relieve the pain. (Stable angina could become unstable angina.) The most common cause is atherosclerosis, or reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildup (plaques). In addition to the narrowing , these plaques can rupture, causing blockages leading to cardiac arrest or stroke. Unstable angina is a medical emergency—someone experiencing it should go to the ED.
- Microvascular angina is a sign of ischemic heart diseases that affects the tiny arteries of the heart and can be stable or unstable. The pain associated with this type of angina can be more intense and last longer than other types of anginas and may occur at rest or with exercise. Medication may not relieve this type of chest pain.
- Variant angina is rare and occurs when the muscles within the arteries of your heart spasm or tighten, interrupting blood flow instead of, or in addition to, plaque buildup. This type of angina usually occurs while you are at rest and often happens between midnight and early morning. Medicine often eases variant angina effectively.
Typically, providers only screen for angina when you have symptoms. Still, providers routinely screen for angina risk factors and recommend preventive strategies, based on those that can be modified.
Risk factors include:
- Advancing age (risk increases for men after age 45 and for women after age 55)
- Family history of early heart disease
- Unhealthy cholesterol levels
- High blood pressure
- History of smoking
- Diabetes or metabolic syndrome
- Being overweight, obese or eating an unhealthy diet
If you are experiencing chest pain regularly—even if you don’t have many risk factors—see a healthcare provider. Depending on its cause, angina can be treated with medications or surgery, but untreated unstable angina can lead to a medical emergency.
Clinically reviewed and updated March 2022.