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Heart Attack, Chronic Chest Pain, & Angina: What's the Difference?

Mar 10, 2015


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What's the Difference Between a Heart Attack and Chronic Chest Pain (Angina)?

No pain, just gain!

Angina, also known as chest pain, occurs when the heart muscle doesn't receive enough blood flow. It is a symptom of coronary artery disease and can cause various sensations in the chest, such as squeezing, pressure, heaviness, tightness, or pain. Angina can be a recurring problem or a sudden, acute health concern. Other symptoms may include fatigue, shortness of breath, dizziness, and nausea.

How Does Angina Differ from a Heart Attack?

A heart attack, or myocardial infarction, happens when a portion of the heart muscle dies or stops working due to a lack of oxygen. While both angina and a heart attack involve chest pain, they are distinct conditions. Angina is a warning sign of coronary artery disease, whereas a heart attack is a more severe event that can lead to permanent heart damage.

Managing Angina with Medical Treatment

For individuals with frequent angina episodes, doctors often prescribe high blood pressure medication and nitroglycerin, a vasodilator that helps increase blood flow to the heart. However, a common side effect of angina and its prescription medication is nausea and vomiting.

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Understanding the Link between Angina and Coronary Artery Disease

Angina is a common symptom of coronary artery disease, a condition where the arteries that supply blood to the heart become narrowed or blocked. When these arteries are restricted, the heart muscle doesn't receive enough oxygen-rich blood, leading to angina. This is an important distinction from a heart attack, as angina is a warning sign of an underlying problem, whereas a heart attack is a more severe event that can result in permanent damage to the heart.

Types of Angina

Angina can be classified into different types based on its characteristics:

1. Stable Angina:

This is the most common form of angina. It typically occurs during physical exertion or emotional stress and is relieved by rest or medication. The symptoms are predictable and usually subside within a few minutes.

2. Unstable Angina:

This type of angina is more serious and unpredictable. The symptoms may occur even at rest and can be more intense and last longer than stable angina. Unstable angina requires immediate medical attention, as it may be a sign of an impending heart attack.

3. Variant Angina (Prinzmetal Angina):

This is a rare type of angina that occurs at rest and is caused by a spasm in the coronary artery. It can be very intense and often happens during sleep, waking the person up with severe chest pain.

Treatment Options for Angina

There are various treatment options available to manage angina and reduce the frequency and severity of symptoms. These include:

1. Medications:

Doctors often prescribe medications to control angina. These may include nitrates, beta-blockers, calcium channel blockers, and ranolazine. These medications work by widening the blood vessels, reducing the heart's workload, and improving blood flow to the heart.

2. Lifestyle Changes:

Adopting a heart-healthy lifestyle can greatly improve angina symptoms. This includes regular exercise, a balanced diet low in saturated fat and cholesterol, maintaining a healthy weight, quitting smoking, and managing stress effectively.

3. Invasive Procedures:

In some cases, when medication and lifestyle changes are not sufficient, invasive procedures may be recommended. These can include angioplasty and stenting, in which a narrowed artery is widened using a balloon or a stent to keep it open, or coronary artery bypass surgery, which involves creating new pathways for blood flow around the blocked arteries.


Q: Can angina lead to a heart attack?

A: While angina is a warning sign of coronary artery disease, it doesn't always lead to a heart attack. However, it is important to recognize and manage angina to reduce the risk of a more severe cardiovascular event.

Q: Does angina only affect the chest?

A: While chest pain is the most common symptom of angina, it can also cause discomfort or pain in other areas, such as the neck, jaw, shoulders, arms, or back.

Q: How can I differentiate between angina and heartburn?

A: Angina and heartburn can have similar symptoms, but they originate from different causes. Angina is caused by reduced blood flow to the heart, whereas heartburn is caused by stomach acid reflux. If you experience chest pain, it is essential to seek medical advice to determine the underlying cause.

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