Angina

If you are having pain or pressure in the middle of your chest, left neck, left shoulder, or left arm, go immediately to the nearest hospital emergency department. Do not drive yourself. Call 911 for emergency transport.
Angina, or angina pectoris, is the medical term used to describe the temporary chest discomfort that occurs when the heart is not getting enough blood.

• The heart is a muscle (myocardium) and gets its blood supply from the coronary arteries.
• Blood carries the oxygen and nutrients the heart muscle needs to keep pumping.
• When the heart does not get enough blood, it can no longer function at its full capacity.
• When physical exertion, strong emotions, extreme temperatures, or eating increase the demand on the heart, a person with angina feels temporary pain, pressure, fullness, or squeezing in the center of the chest or in the neck, shoulder, jaw, upper arm, or upper back. This is angina, especially if the discomfort is relieved by removing the stressor and/or taking sublingual (under the tongue) nitroglycerin.
• The discomfort of angina is temporary, meaning a few seconds or minutes, not lasting hours or all day.

An episode of angina is not a heart attack. Having angina means you have an increased risk of having a heart attack.

• A heart attack is when the blood supply to part of the heart is cut off and that part of the muscle dies (infarction).
• Angina can be a helpful warning sign if it makes the patient seek timely medical help and avoid a heart attack.
• Prolonged or unchecked angina can lead to a heart attack or increase the risk of having a heart rhythm abnormality. Either of those could lead to sudden death.

Time is very important in angina.

• The more time the heart is deprived of adequate blood flow (ischemia), and thus oxygen, the more the heart muscle is at risk of heart attack or heart rhythm abnormalities.
• The longer the patient experiences chest pain from angina, the more the heart muscle is at risk of dying or malfunctioning.

Not all chest pain is angina. Pain in the chest can come from a number of causes, which range from not serious to very serious.

Because angina is usually a symptom of coronary heart disease (heart disease), the underlying cause of angina is usually the same as that of CAD.

With stable angina, severely narrowed arteries may allow enough oxygen to reach the blood when at rest, such as sitting. But physical exertion, such as running to catch the bus, makes the heart work harder and that can trigger the chest pain.

With unstable angina, blood clots partly or totally block the artery, reducing the flow of blood and oxygen to the heart, which triggers angina pain. These blood clots can form, partially dissolve and then form again later, which is what causes the chest pain to come and go unpredictably. A clot that is large enough to completely block the artery causes a heart attack