Angina

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Signs and Symptoms

Angina is a symptom of ischemic heart disease (IHD). Episodes of stable angina typically are brought on by exertion or emotion and are relieved with rest. An attack of stable angina lasts from 1 to 5 minutes and is described as

• squeezing,
  
• choking,
  
• smothering, or
  
• crushing pressure in the chest.
  

Pain may radiate to the shoulders, arms, back, neck, or jaw. Patients with atherosclerosis also may experience sweating, clamminess, shortness of breath (dyspnea), nausea, and a sensation like indigestion.

Unstable angina causes symptoms that are more severe, more frequent, and occur with modestly increased physical activity and at rest. Blood clots may form at anytime and may partially dissolve spontaneously. Whenever this occurs, blood flow to heart tissue is blocked and angina occurs.

An attack of unstable angina may last several minutes to half an hour or longer. Unstable angina is an acute coronary syndrome, which is a medical emergency that requires immediate attention.

Patients with variant angina usually experience intense pain when they are at rest, sometimes waking them from sleep.

Complications

Heart tissue sustains damage within 30 minutes of being deprived of oxygen. A blood clot that completely blocks blood flow in a coronary artery and does not at least partially dissolve will cause heart attack.

Untreated chronic stable angina may progress to unstable angina, an acute coronary syndrome that requires immediate medical attention to prevent the development of

• severe arrhythmias (i.e., irregular heart rhythm),
  
• heart attack,
  
• or sudden cardiac death—due to cardiac arrest with loss of consciousness within 1 hour of the onset of acute symptoms.
  

Possible complications of variant angina include the following:

• Atrioventricular block (i.e., absence of electrical conduction between the atrium and ventricle)
  
• Episodes of disabling pain
  
• Heart attack
  
• Severe arrhythmias
  
• Sudden cardiac death
  

Angina, Signs and Symptoms reprinted with permission from cardiologychannel.com
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