By Dr Ananya Mandal, MD
Angina is commonly manifested as chest pain or discomfort in the chest.
Angina is of two classical types – stable and unstable angina. Stable angina results from atherosclerosis and narrowing of the coronary arteries while unstable angina results from breakage of plaques or fatty deposits on the inside walls of the coronary arteries leading to formation of clots and obstructions.
All symptoms of angina arise due to ischemia or lack of oxygen rich blood supply to the heart muscles. The muscles develop fatigue, and increase in levels of toxic chemicals giving rise to the pain.
The symptoms of angina may be outlined as 1-7 –
- A dull, aching, tightness or heaviness in the chest.
- The pain may spread from the chest to the insides of the left arm, neck, jaw and back.
- Breathlessness or shortness of breath
- Nausea or feeling sick. There may be a general feeling of unwell
- Fatigue or tiredness unrelated to present level of activity
- Patients may complain of dizziness
- There is usually severe anxiety along with the symptoms
- There may be restlessness and need for fresh air due to feeling of breathless or constriction in the chest
- Some patients may manifest with belching or burping
Symptoms of stable angina
In patients with stable angina the dull, aching chest pain is usually brought upon by a bout of physical activity like climbing stairs, having sex or running or even mental upsets or stress.
An attack of angina may be precipitated after a bout of laughing, eating a heavy meal, or going out in particularly cold weather. These factors that lead to an angina attack are termed angina triggers.
The symptoms of stable angina usually last for a few minutes and ease up upon resting for a while as the heart rate slows down and requirement of oxygen of the heart muscles goes down
The symptoms of stable angina are also relieved when the patient is given a medication called Glyceryl trinitrate. This may be applied as a patch over the skin or the pill may be kept underneath the tongue for absorption. The drug leads to dilatation of the arteries and thus relieves the obstruction and eases the chest pain.
Symptoms of unstable angina
Those with unstable angina may not have a specific angina trigger before the onset of the attack.
Unstable angina symptoms persist despite the patient being at rest
Unlike stable angina, unstable angina patients may have symptoms persisting for over 30 minutes and is usually longer than 5 minutes in duration.
Unstable angina is not relieved by glyceryl trinitrate
Unstable angina is a medical emergency and may progress to a myocardial infarction (heart attack) rapidly.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)