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Heart Health Heart Health Basics

Angina (Chest Pain)


Author:

Windsor Ting, MD

College of Physicians and Surgeons, Columbia University

Medically Reviewed On: March 18, 2006

Chest pain or angina is one of the most common symptoms of coronary artery disease. It is usually described as chest pain on the left side, sometime extending down the left arm and up to the jaw. The chest pain frequently comes on with exertion and subsides with rest. It is important to know that angina can be experienced in many different ways: for example, at mealtimes, when exposed to cold weather and stress of all kinds; or as pain on the right side, back, and in the abdomen. Angina can mimic other conditions like reflux, peptic ulcer and gallbladder disease. In some patients, typically a diabetic, coronary artery disease can be silent. Other symptoms of coronary artery disease may include shortness of breath and fatigue.

Frequently Asked Questions

What causes angina?
Angina is caused by an insufficient blood supply to one or more regions of the heart. The most common cause is a blockage in a coronary artery. Infrequent causes are coronary artery spasm and blood clots. Angina is a warning from the heart that it is not getting a sufficient amount of oxygen.

How do I know that I am experiencing angina and not a heart attack?
Angina is usually brief in duration, less severe in intensity, and subsides with rest or with nitroglycerin. In contrast, the chest pain of a heart attack is severe and unrelenting. It may be associated with difficulty in breathing, sweating, light-headedness, and a sensation of doom. When you are doubtful about whether it is a heart attack or angina you are experiencing, seek medical advice immediately.

What should I do if I have angina?
Stop whatever activity has brought on the angina. Sit down and take a rest. If you have a known history of coronary artery disease and your doctor has prescribed sublingual nitroglycerin, take the medication as directed by your doctor.

If you've never experienced these symptoms before, make an appointment to see a physician. If you are uncertain if it is urgent that you see a doctor, speak with your family physician or one of the office nurses. For more severe pain or pain that persists, call an emergency medical service without delay. It is probably best to start with your primary care physician because many causes of chest pain are unrelated to the heart.

What if the angina persists?
If the angina doesn't subside with rest or with several sublingual nitroglycerin tablets, you should treat this as an emergency and call an emergency service for help.

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