Angina: Causes, Risk Factors & Treatments

Angina can be defined as pain, muscle fatigue, or tighteningfelt in the chest region (at or around the heart). The discomfort results mainly from low oxygen supply to the heart tissue which is caused by narrowing or obstruction of coronary vessels. Angina is not a disease, but a symptom of cardio vascular illness that may prove life threatening if no action is taken.

The primary pathophysiological event in angina is the vascular obstruction of coronary vessels because of several reasons, such as vascular degeneration, advanced atherosclerosis, thrombosis, embolism, low oxygen content of the blood or anemia. In untreated or poorly managed cases, risk of severe complications increases, such as heart attack or myocardial infarction, necrosis of blood vessels or even death.

Symptoms of Angina

Chest pain is the most common symptom of angina, but that pain sensation may be different for different people. Some people may experience a burning sensation in the chest, while others may only have slight discomfort or heaviness. Some also complain about feeling fullness in the chest along with a squeezing sensation.

There may also be pain behind your breastbone, which may spread to your arms, shoulders, throat, neck, back, or jaw. Some people do not take this pain seriously and often blame it on heartburn or gas. However, it is a good idea to seek medical assistance if you have a burning sensation in the chest along with pain or discomfort in your neck, jaw, belly, back, or shoulders. Seek immediate medical attention if you experience dizziness or shortness of breath.

Types of Angina

1. Stable Angina

Stable angina is the chest pain felt after excessive physical activity or in any situation when your heart is working harder than it should be (such as after exercise). This type of pain is chronic in nature and is usually predictable. The pain may last up to five minutes or a little more, depending on the nature of interventions employed to manage angina. Your doctor may prescribe an angina medicine or suggest you to limit the intensity of physical activity in order to alleviate chest pain.

2. Unstable Angina

This kind of angina usually occurs before heart attack or stable angina. Unstable angina does not follow the route of a regular angina and is not related with heavy physical exercising. It does not succumb after rest or with medication, and the pain can last up to half an hour in duration. Such angina is more serious in nature than stable angina and are directly associated with a higher risk of cardiac damage.

3. Prinzmetal's Angina

It is the most uncommon variety of angina that presents with most serious symptoms and complications. It may happen when you are rest.

Here is a video link explaining the types of angina with more details:

Causes of Angina

The primary cause of angina is reduced or no blood flow toward the heart. Cardiac muscles are nourished by coronary arteries that are responsible for carrying oxygen rich blood toward the heart. If any blockage occurs in these arteries, your heart tends to underperform its primary function. When you perform physical work, you heart is burdened and pain of angina is felt. This also explains why many people do not feel chest pain when they rest.

Here are some of the causes of different types of angina.


Stable Angina

Unstable Angina

Prinzmetal’s Angina


  • Moderate to severe physical exertion (or even after consumption of heavy meals)
  • Smoking
  • Emotional stress
  • Exposure to cooler temperatures
  • Formation of atherosclerotic plaques
  • Partial or complete occlusion of blood vessel due to blood clots
  • Transient spasm in the walls of coronary vessels due to emotional, hormonal or other triggers

Risk Factors of Angina

Treatment for Angina

In case of stable angina, you start to feel better after some rest. However, unstable angina may get worse with time and often requires surgery. Your doctor usually begins treatment by administering certain medications that help open up blocked arteries. Lifestyle changes may also help to improve blood flow to heart and manage the symptoms.

1. Medications

2. Lifestyle Changes

Certain lifestyle changes can prevent angina attacks and any further complication associated with it. These include exercising regularly, keeping healthy and natural dietary habits, such as keeping diet low in cholesterol and salt and high in antioxidants. Keeping a tab on cholesterol levels and living a life free from stress, smoking and alcohol can minimize the risk of angina greatly.

3. Surgery

If medications fail to produce desired results, your doctor may suggest a medical procedure or surgery. They may suggest the following procedures:

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