According to the National Heart, Lung, and Blood Institute, as many as 7 million people in the United States have angina. So, if you have angina, you’re not alone—but how it feels can vary a lot from one person to the next. Here are a few examples of how people have described it:
“It feels like someone is squeezing my heart and won’t let go.”
“I feel so dizzy and weak that I have to sit down.”
“I know it’s angina because it always starts with pain shooting up my back and across my shoulders.”
“I can’t catch my breath—it scares me.”
“It is more of a discomfort or ache in my chest, not pain. It’s like a pressure.”
Angina can be a frightening experience, especially the first time. If you are having chest pain, trouble breathing or other serious symptoms that last more than a few minutes or return again soon after they stop, call 911. It could be unstable angina or a heart attack.
The symptoms of unstable and stable angina are very similar. They can include any of the following:
- Pain, pressure, or a tightness in the chest, arms, neck, jaw, shoulders or back
- Difficulty breathing or trouble catching your breath (especially common for people with diabetes)
A Special Note About Women: Coronary artery disease and angina affect women as well as men. Women’s symptoms can be more subtle, and some women have reported symptoms days before a heart attack. Like men, women should pay attention to the symptoms of angina described above. In addition, women should pay close attention to the following symptoms and seek immediate medical assistance if they think they could be having a heart attack:
- Sudden onset of weakness, shortness of breath, nausea/ vomiting, indigestion, fatigue, body aches or overall feeling of illness
- Unusual feeling or mild discomfort in the back, chest, arm, neck or jaw
- Sleep disturbance
Stable or Unstable?
Although stable and unstable angina have similar symptoms, they differ in terms of severity and when the symptoms occur. Stable angina is chest discomfort, shortness of breath (or any of the symptoms described above) that happens with a predictable, reliable amount of exertion or stress, and when that pattern has been present for more that four weeks. Stable angina usually starts when you exert yourself or feel stressed. If you stop what you are doing, the pain or discomfort usually stops too. Activity—exercise, eating a big meal, or having an argument—makes your heart rate go up and your blood pressure higher, so your heart works harder. To do the work, the heart needs more oxygen. If it is not getting enough, it can cause the pain and discomfort of angina. When your pattern of angina has been stable for several months, it may be referred to chronic stable angina.
Unstable angina is when symptoms of chest pressure, shortness of breath (or any of the others described above) occur for the first time, or have been happening for less that two weeks. Also, if you have had a change in your usual pattern of angina that occurs with exertion, that also is unstable angina. Unstable angina can happen any time, even when you are resting or sitting in front of the television doing nothing. It’s hard to ignore. If the symptoms stop, they usually return again soon.
Stable angina can become unstable. For instance, if you usually have chest discomfort every time you walk two blocks, that would be considered stable angina. However, if that pattern of chest discomfort changes over the course of a short period of time, then the angina has become unstable. For example, if discomfort comes on with less activity (after walking only half of a block instead of two) or is occurring more frequently than previously, that would be an example of stable angina that has become unstable.
Here are some additional tips for distinguishing between stable and unstable angina:
- is pain or discomfort similar to past episodes of angina with similar amounts of exertion and usually resolves in less than five minutes.
- is chest pain or other symptoms that usually stop after you take medication or stop to rest.
- is triggered by activities that make the heart work harder—physical and emotional exertion or stress, extreme temperatures, or a big meal.
Unstable Angina or a Heart Attack…
- can happen anytime. You could be taking a nap or having a cup of coffee.
- may feel different than the pain or discomfort of stable angina.
- is often more painful or severe and lasts longer than stable angina—more than a few minutes.
- may not go away with rest or use of angina medication.
Remember, unstable angina is a medical emergency. Call 911 if you or someone you love has angina symptoms that last more than 5 minutes and continue when they stop to rest. It could be a heart attack. The sooner you receive treatment, the less damage you risk to your heart.
Getting Help for Angina
If you think you have angina, see your doctor. He or she will work with you to develop a plan to treat it. If you’ve been treating your angina but are still bothered by symptoms that interfere with your daily activities, see your doctor again. And, whether you’re coming up with a treatment plan for the first time or reviewing one that doesn’t seem to be helping, make sure you have gathered all the information you can to share with the doctor.
Try using the SecondsCount Tracking Your Angina Worksheet and review Questions to Ask Your Doctor about Angina to make the most of your time with the doctor. Be prepared to answer questions about yourself and how you’ve been feeling. Open and honest communication with your doctor is one of the most effective tools you have to treat your angina.