Angina is chest pain or discomfort caused when the heart muscle is deprived of oxygen, as it is needed for a given level of work. This is a common symptom for coronary heart disease. Pain occurs when the level of oxygen needed increases due to exertion. A change in physical exercise, extreme temperatures, strong emotions, alcohol, cigarette smoking, or heavy meals may trigger this symptom.

Is all chest pain angina?
Not all pain from the chest is angina. If the pain is relieved in less than 30 seconds, or goes away after drinking a glass of water, changing positions, or taking a deep breath, it is probably not angina and should not cause concern.

Does angina signify that a heart attack is coming?
The pain of angina means that when some of the heart muscle is working, it is not getting enough oxygen. The heart muscle rarely receives permanent damage to the heart muscle. A reoccurring, stable pattern of angina does not mean that a heart attack is about to happen. It means that there is underlying coronary heart disease. People with angina are at an increased risk of having a heart attack compared with those who have no symptoms of cardiovascular disease, but the episode of angina is not a signal that a heart attack is about to happen.

How is angina diagnosed?
The doctor can diagnose angina through symptoms and how they occur. The doctor may then need the assistance of one or more diagnostic tests to either exclude angina or establish the significance of the coronary heart disease. Diagnostic testing may include coronary arteriogram, electrocardiogram, or stress test.

What if medication is unsuccessful in controlling angina?
Doctors may recommend surgery or angioplasty if drugs fail to alleviate angina or if the risk for heart attack stays high. Coronary artery bypass surgery is an operation in which a blood vessel is grafted onto the blocked artery to bypass the blocked or diseased section so that blood can get to the heart muscle. Balloon angioplasty involves inserting a catheter with a tiny balloon at the end into a forearm or groin artery. The balloon is inflated briefly to open the vessel in places where the artery is narrowed. Laser and mechanical devices applied by catheters are also being developed for opening narrowed coronary arteries.

What is the difference between "stable" and "unstable" angina?
Stable angina is when the level of activity or stress that provokes the angina is somewhat predictable, and the pattern changes slowly.

Unstable angina needs quick medical attention.

What is the treatment for Angina?
Attacking the existing risk factors in the patient should help control angina. Examples of some risk factors could be excess weight, high blood pressure, cigarette smoking, and high blood cholesterol levels. Information on controlling blood pressure, weight, and blood cholesterol is available. Physicians can assist patients who are trying to discontinue smoking. Eliminating these risk factors can reduce the chances that coronary artery disease will lead to a heart attack.

Medication is sometimes used to control angina. Nitroglycerin is prescribed when discomfort is expected or occurs and relieves pain by widening blood vessels. Beta-blockers slow the heart rate and lessen the force of the contractions of the heart muscle. Calcium channel blockers help reduce the severity and frequency of angina attacks.