When the heart does not receive sufficient oxygen-rich blood flowing through it, discomfort and chest pain result. This chest pain is called “angina.” Some people describe angina as pressure or a tightness in their chest. Angina is not a disease. Rather, angina is a symptom of other issues occurring with the heart, usually coronary heart disease.
There are several types of angina. Angina pectoris is one common type of angina. Other types include stable angina, unstable angina, variant (Prinzmetal’s) angina, microvascular angina, and atypical angina. Different types of angina have different symptoms and different triggers that cause the symptoms.
Stable angina describes angina pectoris. This type of angina occurs in connection with coronary heart disease when the heart is deprived of sufficient amounts of blood. This situation typically occurs due to narrowing of coronary arteries. Blocked arteries may enable sufficient blood flow to the heart during periods of rest or light physical exertion. However, when the heart must pump faster to keep up with more physical exertion, the narrowed arteries will not allow enough blood to flow through them and angina (chest discomfort) will occur.
Unstable angina is also considered an “acute coronary syndrome.” With unstable angina, chest pain occurs unexpectedly, even at rest. The disease that occurs with stable angina has progressed to the point of not being stable or predictable. Atherosclerosis, fatty buildup in coronary arteries, may lead to a rupture. This could completely block blood flow to the heart. Unstable angina is an emergency situation that could lead to a heart attack.
Variant or Prinzmetal’s angina is an uncommon type of angina, typically occurring in younger people. Variant angina usually happens while a person is sleeping during the overnight hours. This type of angina is exceedingly painful, and it occurs from a spasm of the coronary arteries.
Microvascular angina is often associated with coronary microvascular disease. This type of heart disease involves the smallest blood vessels of the heart. When these tiny blood vessels spasm, or become blocked, the flow of blood to the heart becomes restricted. This restriction causes angina symptoms.
Some people experience angina that does not fit the normal symptom parameters. This type of angina is called atypical angina. The symptoms of atypical angina include an indistinct discomfort in the chest, nausea, fatigue, indigestion, shortness of breath, and pain in the neck and back. Women usually experience atypical angina more than men do.
Angina typically involves a group of symptoms. If pain or pressure in the chest lasts more than a moment or two and does not subside with rest, get medical assistance immediately.
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Written by Judith Haluka and last updated Jan 28, 2015
Last reviewed by Michael A. Tomeo MD on Nov 25, 2017