Angina Pectoris, more commonly known as chest pain, is a sign that the heart needs more oxygen.

Angina can be caused by an insufficient supply of blood and oxygen to the heart muscle. The body responds to this oxygen deprivation with pain (many people refer to the pain as tightness or pressure) in the chest, arms, shoulders, neck and/or jaw. Some people also experience shortness of breath, fatigue, sweating, dizziness and/or vomiting. It is most frequently caused by narrowing of the coronary arteries. The narrowing is due to buildup of fatty deposits (plaque or Atherosclerosis) within the artery walls.

Remember, you may not have chest pain as your heart disease equivalent. If you have symptoms that are not readily explained, always think about heart disease. It is the number one disease that affects Americans.  Do not ignore your warning signs, as they may be an indicator of an impending cardiac event. Angina usually lasts several minutes. If your angina lasts more than 5 minutes, don’t delay in getting help. Dial 9-1-1 right away. Do not drive yourself to the hospital.

There are two types of angina:
Stable angina typically occurs when you exercise or feel stress, so it is somewhat predictable, and it feels the same way each time. Stable angina usually disappears when you rest and/or take your medication.

Unstable angina is less predictable and may occur even when you rest. It can occur more frequently, feel more severe, and/or last longer than stable angina. Your doctor may be more concerned about unstable angina, since it can mean there is a blocked artery in your heart. In some people, unstable angina can be a sign of a heart attack.

What is the cause?
Angina is most often caused by plaque buildup in the coronary arteries (heart arteries). Plaque is made up of fatty substances, like cholesterol, in your blood. The plaque builds up slowly, over a number of years. In time, plaque can harden and narrow the coronary arteries. Eventually the plaque can slow or block blood flow to the heart, cut off the oxygen supply, and cause angina.

Atherosclerosis is the general medical term for plaque buildup that clogs arteries. Coronary artery disease (CAD) is the medical term for atherosclerosis in the coronary arteries in particular. Angina, therefore, often results from atherosclerosis and from CAD.

Of course, chest pain is not always caused by reduced oxygen supply to the heart. Sometimes, chest pain is not related to heart vessel blockages at all. It could instead be related to valvular heart disease, other structural heart disease, or a lung condition.

How is chest pain evaluated?
If you have angina, your doctor may suggest one or more tests to find out the underlying cause. The test results can also help your doctor choose the best treatment(s) for you.

What are the treatment options for angina?
There are a variety of treatment options for angina which are targeted according to the cause of the pain. They include:

• Procedure(s) that open narrowed arteries (for example, Angioplasty) and Coronary Artery Bypass Surgery
• Medication(s) (such as Nitroglycerin, Beta Blockers, Calcium Channel Blockers) and ACE Inhibitors
• Lifestyle changes to reduce your risk factors (e.g. smoking cessation, exercise, diet, etc).

Changing your lifestyle to reduce your risk factors is one of the most important steps you can take to improve your overall cardiovascular condition.