What is it?

Angina is defined as pain or pressure in the chest, and it can come in four different types: stable angina, unstable angina, variant (Prinzmetal's) angina and microvascular angina. All types of angina feature pain or pressure in the chest, which can spread to the jaw, chin, shoulder and even extend into the upper arm. It is quite common for heart induced chest pain to be mistaken for indigestion or heart burn, initially at least. Fatigue and shortness of breath can also be present and episodes can be triggered by periods of exertion.

Types of Angina

  • Stable angina occurs at fairly regular intervals, and is considered to be an early warning for an eventual heart attack.
  • Unstable angina happens suddenly, can be without prior warning and requires urgent medical treatment as it can indicate that a heart attack is imminent.
  • Variant or Prinzmetal's angina occurs during periods of rest, and therefore, often happens at night. Variant angina can usually be controlled with medication.
  • Microvascular angina is more insidious, striking people who do not have significant blockage or narrowing of major blood vessels. As the name indicates, this type of angina is caused by issues in the tiny cardiac blood vessels. Medication is not always effective against this type of angina and the pain can last longer and feel worse than with the other types.


Angina's causes are set off by problems with the patient's blood flow, as vessels become narrowed. Many people do not realize that angina is not a disease in its own right, it is rather just one symptom of a much wider problem – coronary heart disease. It is possible for people to suffer from heart problems without suffering from angina, so in a way angina is useful as it helps sufferers to realize that changes need to be made to their lifestyle before something like atrial fibrillation reveals the extent of the problem.


Nitrates are commonly prescribed to ease angina and they work by dilating the blood vessels, increasing blood flow to the heart. Other medications work by lowering blood pressure and preventing clots. Patients can take a very pro-active approach to their heart disease and take steps to follow a natural, heart-healthy diet filled with plenty of fresh fruit and vegetables, take regular gentle exercise and eradicate as much harmful stress from their lives as possible.

If the medications do not work well, and lifestyle changes make no difference to the constricted veins medical professionals may recommend a surgical procedure known as an angioplasty. This process involves a thin flexible tube (known as a catheter) being threaded through the major blood vessels to reach the problem area. Once it is in place a small balloon on the end of the tube is inflated, essentially squashing the plaque build-up into the walls of the vessel, leaving a wider, clearer path for the blood to flow through. As the operation is non-invasive most patients can leave the hospital the next day, and return to work within a week or so of the procedure. Complications are rare, and usually involve infection around the catheter site, rather than issues with heart, although they can happen. There will be medications after the operation to prevent the formation of blood clots and to aid recovery.

To summarize:
  • Angina is a symptom of heart disease, not a disease on its own
  • Angina treatment can range from simple lifestyle changes to surgery, depending on its severity
  • Women can have 'atypical' angina symptoms – where pain or discomfort is felt in the back and jaw, rather than in the chest.