Angina is recurring pain or discomfort in the chest that results from temporary inadequate blood flow to the heart. The pain is characterized as squeezing or crushing pain originating in the center of the chest, behind the breastbone. Pain may also be felt in the shoulders, arms, neck, jaws or back. In addition, there can be a heavy feeling or feeling of tightness, pressure or squeezing in the chest.  

 
Angina is most commonly due to coronary artery disease the build up of plaque in the arteries which reduces the blood flow to the heart and deprives the heart of oxygen. When the heart is subjected to exertion, such as exercise, it cannot keep up with the increased demand for blood, resulting in chest pain. Other diseases, such as aortic valve disease, can also cause angina.

In addition to physical exertion, angina can be triggered by stress, alcohol, nicotine, or extreme cold or heat. This classic type of angina is known as stable angina and follows an established pattern of symptoms and is relieved by rest or medication. Some people experience chest pain and discomfort unexpectedly and while at rest. This more acute form of angina unstable angina can be a warning sign of more serious heart problems, such as a heart attack. Unstable angina should be treated as an emergency. Variant or Prinzmetals angina is a form of unstable angina that causes coronary artery spasms. Angina is not a heart attack, although the pain is similar. Pain from a heart attack is more severe, lasts longer and does not respond to rest or medication used to treat angina.

The initial diagnosis of angina can often be made based on the symptoms and their patterns. Tests can determine the underlying cause of the angina and the presence and extent of coronary artery disease. These tests include an electrocardiogram (ECG), exercise stress test, nuclear imaging, echocardiogram and cardiac catheterization.

Treatment for angina depends on the severity and underlying cause. Lifestyle changes including proper diet, regular exercise, controlling high blood pressure and cholesterol levels, and quitting smoking, can help control angina. Medication can also be used to control and relieve symptoms. The most popular medication is nitroglycerin, which widens the blood vessels to improve blood flow and decrease the workload on the heart. It is taken when discomfort occurs or is expected, and takes effect in seconds. Other medications, such as calcium channel blockers and beta blockers, are used to decrease the hearts workload.

In cases where the angina does not respond to lifestyle changes and medication, or the risk of heart attack is high, coronary artery bypass surgery or angioplasty may be necessary.

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