Angina or chest pain is more of a symptom than a condition. It is indicative of an underlying cardiovascular and heart disease like coronary artery disease. Angina or angina pectoris may or may not be a medical emergency. It depends upon the exact cause of the pain.
What is angina?
Angina is chest pain accompanied by discomfort. People who experience angina describe their pain as:
- Crushing pain
- Pressure sensation and heaviness in the chest area
- Radiating pain that spreads towards the neck, jaw, or back
Some people might relate angina pain as a squeezing sensation with a sensation of indigestion, burning, and fullness.
Angina pain may also be accompanied by weakness, shortness of breath, sweating, and a sensation of nausea and vomiting. When accompanied by these symptoms, it is better to rush to a hospital immediately. On the other hand, people might also experience angina without any other symptoms.
Note: Angina pain generally lasts for about 15 minutes; however, if a person experiences chest pain that lasts for more than 5 minutes even after resting or lying down, it may be a medical emergency. One needs to be rushed to the ER immediately.
Types of angina
There are different types of angina depending upon the underlying cause of the chest pain. A person experiences angina when the heart muscles do not get adequate oxygenated blood. This happens when the coronary arteries (arteries that supply oxygen-rich blood to the heart) are blocked or get narrow.
The types of angina include:
- Stable angina
- Unstable angina
- Variant angina (Prinzmetal’s angina)
- Microvascular angina
Note: Chest pain can be caused due to many reasons apart from heart diseases. That is why it is important to describe your pain to the doctor in detail. Description like the duration of pain, sharpness or dullness of pain matters a lot.
Stable angina is a chest pain that occurs when there is physical exertion with exercise or there is severe emotional distress. This type of angina or chest pain goes away with rest. Though this kind of angina is not a medical emergency, it needs medical attention and has to be treated. If left untreated, it can lead to sudden heart attack.
Stable angina is a symptom of coronary artery disease.
Stable angina symptoms
- Chest pain after physical exertion
- Pain lasts for not more than 5 minutes
- Pain that disappears with rest or medication
- Stable angina feels like having gastric problems or indigestion
- Shortness of breath
- Heart palpitations
People with diabetes have a higher risk of heart disease. They carry a risk of coronary artery disease. Due to reduced pain sensation in diabetes, many people might have varied perceptions regarding stable angina. They might consider this as more of indigestion rather than angina. This condition is also called as silent ischemia. That is why it is important for people with diabetes to get their heart assessment once or twice a year depending upon the recommendations of their diabetes doctors.
Controlling blood glucose levels, HbA1c, blood pressure, and cholesterol levels reduces the risk of heart attacks. Along with that, getting physical activity, reduction of weight, and screening for psychological issues with smoking cessation helps reduce risks.
This kind of chest pain is associated with a heart attack. This kind of angina can occur while one is physically active or even at rest. Unstable angina starts suddenly and gets worse. This condition needs immediate medical attention and one has to be rushed to a hospital.
Delay in providing medical attention can lead to permanent damage to the muscles of the heart. This can turn fatal.
Unstable angina symptoms
- Pain and pressure sensation in the chest
- Pain that radiates to the neck, jaw, back, and shoulders
- Extreme sweating
- Shortness of breath
- Sudden and extreme weakness
Unstable angina is a sign of a heart attack, and acute coronary problems. It demands hospital admission and complete bed rest with further investigations.
People with uncontrolled diabetes are at a higher risk of getting unstable angina. They are also at a higher risk of getting heart attacks. That is why it is important for people with diabetes to work on heart attack prevention by:
- Prevention of hypertension or controlling high blood pressure
- Get normal cholesterol levels
- Improve blood glucose control
- Reach target HbA1c
- Reduce weight
- Stay physically active
This type of chest pain is unlike other kinds of angina. It generally occurs during rest especially during midnights and early mornings. Variant angina is more common among younger people and are characterized by severe pain. However, this kind of angina pain is reduced with medication.
This type of chest pain occurs when there is a microvascular disease of the heart. This heart disease is called coronary microvascular disease. In this condition, the small arteries of the heart have reduced blood flow.
Chest pain in this condition is different from other types of angina. Pain often lasts for more than 10 minutes up to 30 minutes.
Microvascular angina symptoms
- Chest pain that lasts longer than other types of angina
- Pain might occur along with other symptoms like shortness of breath, fatigue
- Is noticed in times of mental stress and during physical activities
Diabetes is a major cause for heart disease. People with diabetes generally experience a condition called coronary microvascular dysfunction. This because diabetes causes damage to the small and tiny blood vessels.
Insulin resistance, and high blood sugar levels damage the small blood vessels of the heart and lead to coronary microvascular disease.