Chest Pain

What is angina?

Angina — or angina pectoris — is a symptom of an underlying cardiovascular condition that reduces the flow of oxygen-rich blood to your heart. It causes a feeling of intense pressure, squeezing, burning, tightness, discomfort, or pain in your chest, usually right behind your breastbone.

For some people, angina causes pain that radiates through the arms, shoulders, back, neck, or jaw. Some patients experience no pain, but other symptoms, known as “angina equivalents” can occur, such as:

• Nausea or indigestion
• Weakness and fatigue
• Shortness of breath
• Dizziness or fainting

Although coronary microvascular disease, stenotic aortic valve, or a spasm of the coronary artery can cause angina, it’s most often the effect of atherosclerosis or coronary heart disease (CHD).

CHD occurs when a waxy substance called “plaque” builds up inside the walls of your coronary arteries, causing them to narrow, stiffen, and reduce the amount of oxygen-rich blood that reaches your heart. 

Are there different types of chest pain?

Chest pain takes different forms, each with distinct hallmarks:

Stable angina

Stable angina, the most common, predictable form of the condition, happens when angina is triggered by exercise. It usually lasts a few seconds to a few minutes, and typically disappears with rest or nitroglycerin.

Unstable angina

This medical emergency — which may be a sign of an impending heart attack — can occur even at rest. Besides being unpredictable, unstable angina tends to be more severe and longer-lasting.

Unstable angina doesn’t usually respond to rest or medication and should be treated in a hospital. Recognizing the features of this severe condition can be life-saving.

Am I at risk of developing chest pain?

Because CHD causes the vast majority of angina cases, anything that increases your risk of developing CHD also increases your risk of developing angina. Major risk factors include:

• Tobacco use
• High blood pressure
• Unhealthy cholesterol levels
• Family history of premature heart attacks
• Diabetes mellitus

You also have a higher chance of developing chest pain if you are a man older than 45, or a woman older than 55.

How is chest pain treated?

The primary goal of treatment is to decrease the incidence and severity of symptomatic episodes, while simultaneously reducing your chances of having a heart attack.

This may mean taking medications like aspirin (which promotes easier blood flow through narrowed vessels), beta-blockers (which reduce blood pressure and heart rate), and statins (which lower cholesterol levels and are potent vascular anti-inflammatories).

When an episode of chest pain occurs, taking sublingual (under the tongue) nitroglycerin can be life-saving.

Making healthy lifestyle changes can also be very beneficial. As with all conditions that affect the heart, this includes quitting smoking, losing weight, safely increasing your activity levels, and switching to a heart-healthy diet.

For patients who can’t control their chest pain with medications, Dr. Yashar may recommend coronary interventions, which include angioplasty, stenting, and coronary artery bypass grafting.

To learn more about how chest pain is treated, call Payam R. Yashar, MD, or request an appointment online today.