Angina Pectoris or Angina

Angina pectoris is the medical term for chest pain or discomfort due to coronary heart disease. Angina is a symptom of a condition called myocardial ischemia. It occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs. This usually happens because one or more of the heart's arteries (coronary blood vessels that supply blood to the heart muscle) is narrowed or blocked. Insufficient blood supply is called ischemia.
Angina also can occur in people with valvular heart disease, hypertrophic cardiomyopathy (this is an enlarged heart due to disease) or uncontrolled high blood pressure. These cases are rare, though.
Typical angina is uncomfortable pressure, fullness, squeezing or pain in the center of the chest. The discomfort also may be felt in the neck, jaw, shoulder, back or arm. Many types of chest discomfort aren't related to angina. Acid reflux (heartburn) and lung infection or inflammation are examples.
When does angina pectoris occur?
Angina often occurs when the heart needs more blood. For example, running to catch a bus could trigger an attack of angina while walking might not. Angina may happen during exercise, strong emotions or extreme temperatures. Some people, such as those who experience coronary artery spasm, may have angina when they're resting. (See below, unstable angina, Prinzmetal's or variant angina pectoris.)
Angina is a sign that someone is at increased risk of heart attack, cardiac arrest and sudden cardiac death.
What is stable angina?
People with stable angina (or chronic stable angina) have episodes of chest discomfort that are usually predictable. They occur on exertion (such as running to catch a bus) or under mental or emotional stress. Normally the chest discomfort is relieved with rest, nitroglycerin or both.
People with episodes of chest discomfort should see their physician for an evaluation. The doctor will evaluate the person's medical history and risk factors, conduct a physical exam, order a chest X-ray and take an electrocardiogram (ECG). Some people will also need an exercise ECG (stress test), an echocardiogram or other tests to complete the diagnosis.
What is unstable angina?
In people with unstable angina, the chest pain is unexpected and usually occurs while at rest. The discomfort may be more severe and prolonged than typical angina or be the first time a person has angina. The most common cause is reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildups (atherosclerosis). An artery may be abnormally constricted or partially blocked by a blood clot. Inflammation, infection and secondary causes also can lead to unstable angina. In a form of unstable angina called variant or Prinzmetal's angina, the cause is coronary artery spasm.
Unstable angina is an acute coronary syndrome and should be treated as an emergency. People with new, worsening or persistent chest discomfort should be evaluated in a hospital emergency department or "chest pain unit" and monitored carefully. They're at increased risk for:

• acute myocardial infarction (heart attack).
• severe cardiac arrhythmias. These may include ventricular tachycardia and fibrillation.
• cardiac arrest leading to sudden death.

What is variant angina pectoris (Prinzmetal's angina)?
Variant angina pectoris is also called Prinzmetal's angina. It usually occurs spontaneously, and unlike typical angina, it nearly always occurs when a person is at rest. It doesn't follow physical exertion or emotional stress, either. Attacks can be very painful and usually occur between midnight and 8 a.m.
Variant angina is due to transient coronary artery spasm. About two-thirds of people with it have severe coronary atherosclerosis in at least one major vessel. The spasm usually occurs very close to the blockage.

 

i have had angina attacks my self due to high BP and my dr put me on Atenolol to lower my BP cause i was having angenia attacks at least once a month. I have also cut my salt/sodium intake to help. but there have been times of stress that it shows its lil head....

 

I quite often have an attack of angina....right after mama says "maybe later dear"....after the pain and arrhythmia pass...then the stress and the "little head" disappear!

Sorry....just couldn't resist!

 

Oh yeah? You live in East L.A. or Watts?

 

I had angina also, got it fixed with open heart surgery and never had a heart attack.

aka Preventive Maintenance.

 

My neighbor is an ER nurse and says many different things actual present (in the ER) as a heart attack--and turn out to be something else. They(er personal) treat all cases the same(as if it is cardiac arrest)until tests are run that determine what it is.
So having said this IMHO there is no way to tell if it is one or the other--So I would humbly suggest as strongly as I can--Go back to your Dr. and get a full workup and find out! If there is a problem--you can get ahead of it--and if it is something else--that can be dealt with also. So do yourself a favor.
Just my $.02

 

To echo and amplify what Spud and 'Olhand said, and speaking now as a retired paramedic rather than just as a radio tech: All chest pain is presumed to be a myocardial infarction (classic "heart attack") until proven otherwise. That's why the absolute first thing you should do when you experience chest pain is call 911. Not your buddy, unless he's in the truck or room with you.
An actual heart attack occurs when a clot clogs one of the arteries that supplies blood to the heart muscle itself; the heart doesn't get oxygenated simply by handling blood. The ischemia, or oxygen starvation, sends pain impulses to the brain. Left untreated, the affected tissue will die. The size and location of the affected tissue determines whether the person will die.
The pain of a heart attack *may* come and go over minutes or hours, but will not be affected by activity. Angina is typically temporary, and accompanies an increased demand for oxygenated blood by the heart muscle for increased activity of some kind: fight-or-flight, excitement, sex (even bad sex is still work for the heart), heavy lifting, etc. A key difference is that angina *usually* diminishes when the activity that precipitated it is stopped. It can be largely self-limiting. If your chest hurts when you run, you're likely to stop running.
The pain from a true heart attack only coincidentally accompanies exertion. Long-standing atherosclerosis, the build-up of plaque in the coronary arteries, already sets the threshold lower for activity that will trigger pain, because the arteries are already partially closed. In some cases the extra ischemic event will put tissue that was on the edge of survival past where it can tolerate, and may induce an erratic rhythm ("dysrhythmia") because of bad electrical conduction through the nerves and muscle tissue of the heart. Some dysrhythmias (bad rhythms) can become an arrhythmia (no rhythm).
Prinzmetal's Angina was mentioned, too. It's a special case, and is thought to account for heart attacks where no clot is found upon autopsy. It is believed that the arterial spasm can hold a coronary artery or arteries tightly enough and for long enough that no blood flows through for long enough to kill a "critical mass" of heart muscle. Upon death, the vessels relax, and the dead tissue is found, but without a clot.
With fast enough intervention (translation: an emergency room, or in some cases, paramedics) many heart attacks can be corrected by medicines called clot busters, or by catheters that pull or blow out clots. But they can't work if the patient isn't entered into the emergency medical system.
Kinda sounds like angina and heart attacks appear similar, huh? That's why chest pain patients *all* get an I.V. (for a medication pathway), oxygen (to increase the percentage of oxygen in the blood that does get to the heart, nitroglycerine and/or Morphine Sulfate (to relax coronary arteries and ease respiration, and relax the patient), and a calm, prudently swift ride to the ER.
Please don't try to drive yourself; black out and the number of victims is likely to go up. Please don't have a friend drive you; they're likely to be agitated and drive badly, scaring everyone (and increasing your heart's oxygen demand). Best bet is to call 911, and the first words you say should be your physical location, then "chest pain".
Please, please, let the EMS system bring the emergency room to you. Speaking from experience, firemen would much rather get turned around enroute to an "injuries unknown" scene than not be called until too late and have to do a pronouncement of death.

So yeah -- what those other guys said. I've had to pull the sheet over too many people whose families said, "Yeah, he said his chest (or shoulder, or neck, or back, or arms, etc.) felt funny since last night, and this morning he just didn't wake up."