Angina itself is not a disease. Much evidence indicates that onset of angina less than 48 hours before a heart attack may be protective, possibly by conditioning the heart to resist the damage resulting from the attack. Angina may be experienced in different ways and can be mild, moderate, or severe.
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Specific factors are typically considered in determining whether symptoms indicate angina:
- Quality of the pain. Angina pain is typically described by patients as squeezing, heavy, suffocating, or griplike. It is rarely described as stabbing or burning. Changing one's position or breathing in and out does not affect the pain. The intensity of the pain does not always relate to the severity of the medical problem. Some people may feel a crushing pain from mild ischemia, while others might experience only mild discomfort from severe ischemia. In some cases, the patient experiences shortness of breath, fatigue, or palpitations instead of pain. In others, the ischemia is entirely asymptomatic ("silent ischemia").
- Duration. A typical angina attack lasts minutes. If it is more fleeting or lasts for hours, it is probably not angina.
- Location. Pain is usually in the chest under the breast bone. It often radiates to the neck, jaw, or left shoulder and arm. Less commonly, patients report symptoms that radiate to the right arm or back.
- Triggers of Angina. Angina is usually triggered by physical exertion, emotional stress, or exposure to cold.
- Factors that Relieve Angina. Angina is usually relieved by rest or by taking nitroglycerine under the tongue.
Stable Angina. Stable angina is predictable chest pain. Although less serious than unstable angina, it can be extremely painful. It is usually relieved by rest and responds well to medical treatment (typically nitroglycerin). Any event that increases oxygen demand can cause an angina attack. Some typical triggers include:
- Exercise
- Cold weather
- Emotional tension
- Large meals
Angina attacks can occur at any time during the day, but most occur between 6 AM and noon.
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