Guide To Angina
|Having Trouble Describing Your Symptoms?
Don't worry. Many women who experience angina struggle to describe their symptoms. It certainly requires a lot of descriptive words! Pain can be suffocating, crushing, radiating or tight and band-like. It can build up to a crescendo before disappearing or may just feel like a dull pressure in the chest. It can feel severe enough to be mistaken for a heart attack or mild enough to feel like a bout of indigestion. Studies show that patients often down play their symptoms when talking to doctors or else describe them in such an untypical way that the doctor fails to diagnose it as angina. As a result, chest pain in women is often attributed (by women themselves as well as their doctors) to other causes such as stress, tiredness, indigestion or other digestive complaints. As angina is very often a symptom of coronary heart disease (CHD), diagnosing and treating it early can help prevent heart attacks. For this reason, any woman who is experiencing regular chest pain should keep a heart diary. This is a good way to pinpoint and track symptoms which makes an angina diagnosis much easier.
What Are The Signs of Stable Angina?
Angina is considered stable where symptoms have remained the same for months and are predictable. Typical symptoms of stable angina include pain that:
1. Is bought on by an activity that makes the heart work faster - for example, exercise, stress and cold temperatures.
2. Starts in the left side of the chest and radiates down the left arm (although it can extend down the right arm, image).
3. Sometimes extends to the jaw, arm, shoulder or back.
4. Does not come as a surprise, the patient can usually predict what activity will cause an attack.
5. Lasts a few minutes and disappears with rest or with taking nitrate medications.
6. May be described as an unpleasant sensation of fullness in the chest. A sensation similar to indigestion.
7. Is sometimes described as 'squeezing'.
8. During an attack the person looks pale and becomes very quiet.
Traditionally the following are less associated with stable angina, but may still occur:
1. Shortness of breath.
4. Sudden sweating.
What About Unstable Angina?
When angina becomes unstable it means that symptoms are spiraling out of control. It is a warning sign that a heart attack might strike soon. It occurs when one of the coronary arteries which supply blood to the heart become suddenly blocked by a blood clot. It is a medical emergency and requires immediate medical intervention (angina treatment). Common signs that angina has become unstable are:
1. Pain which is more severe than normal.
2. Pain which occurs while at rest or sleeping.
3. Pain comes as a surprise and can be accompanied by nausea, weakness or fainting. See also, why do I feel faint?
4. It does not improve after taking 2 or 3 nitroglycerin pills.
5. Pain lasts longer than 20 minutes.
If you experience any of the above, call for an ambulance immediately. Heart disease in women can present differently to men. Although chest pain like angina can be a typical sign of clogged arteries (atherosclerosis) and a potential warning sign of a heart attack, studies show that fewer than one third of women who have heart attacks experience chest pain in the preceding 4 to 6 months. Women are far more likely than men to experience atypical subtle symptoms of angina such as dizziness, weakness and shortness of breath.
Read more: CHD in women.
What Are The Signs Of Microvascular Angina?
Also known as Cardiac Syndrome X (CSX), this type of angina is not related to clogged coronary arteries but rather due to some sort of muscle constriction in the minor blood vessels (capillaries) which supply the heart. The condition is still not well understood by scientists, although it tends to be more common in those with risk factors for heart disease. Signs include:
1. Similar to typical angina, CSX can produce chest pain described as crushing or burning. Pain or numbness can extend to the shoulders, jaws and arms.
2. Unlike typical angina, chest pain can last longer than 30 minutes. In fact it can last longer than all other types of angina pain.
3. Symptoms are first usually noticed during routine daily activities (such as cooking, cleaning or going to work). Typical angina on the other hand is usually experienced during physical activity such as jogging or walking fast.
4. Shortness of breath.
5. Sleeping difficulties.
6. Tiredness (fatigue) and lack of energy.
7. Medications do not always relieve symptoms.
What Are The Signs of Variant Angina?
Also known as coronary artery spasm and Prinzmetal's, this is where the muscles in the walls of the coronary arteries temporarily spasm causing a restriction of blood flow. If the spasm lasts long enough it may even cause a heart attack. About 2 percent of patients with angina have variant angina. It typically occurs in younger women under the age of 50. It is a form of unstable angina which means an attack can occur without warning (the pattern is 'variant'). Symptoms include:
1. Chest pain which may be described as crushing, squeezing, tight or constricting.
2. Pain can spread down the arms, back and to the neck.
3. Pain usually appears between midnight and 8am and lasts 5 to 30 minutes.
4. Although there may no obvious trigger some patients report extreme stress, exposure to cold and hyperventilation as triggers.
5. Medications tend to relieve symptoms.
What Is NOT Angina?
There are many different causes of chest pain, some of which are not related to heart disease. The following are a list of symptoms which are not characteristic of angina:
1. Sharp, knifelike pain bought on by breathing or coughing.
2.Discomfort mainly in the lower or middle abdominal region.
3. Pain that can be pinpointed with the tip of one finger, particularly over the left breast.
4. Constant pain which lasts for hours.
5. Very brief pain which last a few seconds.
6. Pain that spreads to the legs.
My Doctor Wants To Know If I Have Chest Pain But I Don't Have 'Pain'. It Feels More Like A Pressure In My Chest. Should I Say Yes?
Do say 'yes'. Chest pain in women can vary and any pain or pressure in the region may come from the heart. While some women might feel an obvious pain, others describe a vague pressure. If the pressure tends to come on with exercise but disappear with rest it is likely to be caused by heart disease.
Can Angina Pain Last Hours?
Most pain which extends beyond a few hours is more likely to be caused by other problems such as a digestion disorder like GERD (acid reflux). In comparison an angina attack typically lasts between 5 and 10 minutes. That said, microvascular angina can cause pain which last several hours. If you have other questions, visit our popular section on womens health questions.
Do I Have Mild Or Severe Angina?
If you can carry out a lot of strenuous activities before triggering an angina attack, your symptoms are considered mild. This means that the narrowing of your arteries is not very severe or that narrowing is in an area which only supplies blood to a small part of the heart muscle. People who suffer an attack with very little activity are considered to have a more severe version of angina and it is usually an indication of more blockages/narrowing in the arteries, or that narrowing occurs in an area which supplies a lot of blood to the heart muscle.