The 2 Types of Angina and Common Treatments

Angina is a medical condition that is Latin for tightening or squeezing of the chest. Angina is chest pain or other discomfort that commonly occurs when there is a reduction of blood oxygen supplied to an area of the heart muscle. During most cases the lack of blood supply is commonly caused by narrowing of the coronary arteries which is called arteriosclerosis.

Angina is usually characterized by pressure in the chest, heaviness, tightening, squeezing or pain across the breastbone. Sometimes the pain radiates to the jaw, neck, arms, back or in some cases the teeth.

Some patients may also experience indigestion, heartburn, weakened feeling, sweating, nausea, cramping or in some cases shortness of breath.

Angina commonly occurs during periods of exertion or severe emotional stress. Sometimes it occurs after heavy meals. During periods of angina the heart muscle basically is demanding more oxygen than the narrowed arteries can deliver and the discomfort typically lasts anywhere from 1 to 15 minutes. The discomfort is usually relieved through resting or by placing a nitroglycerin pill sublingual, which is under the tongue. The nitroglycerin relaxes the vessels and lowers the BP which with rest decreases the heart’s need for increased oxygen and relieves the angina.

There are two types of angina.

Stable Angina is the most common type and what most people mean when they say they have angina. People with stable angina have angina symptoms on a regular basis but they are predictable such as with overexertion. This type of angina commonly lasts for less than 6 minutes and is relieved by resting and taking medication such as the nitroglycerin.

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Unstable Angina is the typically less common type and much more serious. The symptoms are unpredictable and pains are commonly more frequent and last longer. Sometimes the angina may occur at rest and may be not relieved with nitroglycerin or the patient needs to use more than usual nitroglycerin to get relief. Unstable angina is however not the same as a heart attack but it does warrant immediate attention by a medical professional or emergency room. This type of angina requires cardiac testing to be done and unstable angina is often a precursor to a heart attack.

Treatment options for angina include:

Rest – Angina patients are commonly told if they have any pain to take their medication and immediately sit or lie down for a period of time to see if the pain subsides.

Medications – Typical angina medications include nitroglycerin, beta blockers or calcium channel blockers.

PTCA – PTCA is commonly referred to as angioplasty or percutaneous transluminal coronary angioplasty

CABG – CABG means coronary artery bypass graft surgery

New drugs are being studied for treatment of angina. In 2006 Ranexa was approved but because of its side effects with the potential of causing abnormal heart rhythm, it is only indicated when other conventional medications are found to be ineffective.

Angioplasty and coronary bypass surgery

When patients continue to have angina despite commonly recommended medical treatments, cardiac catheterization with arteriography may be indicated. Depending on the location and severity patients may be recommended to have an angioplasty (PTCA) or a CABG in which to increase blood flow to the heart.

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If you have angina or are having any of these symptoms you should discuss with your physician all the benefits, risks and alternatives that you may have for your symptoms or angina type. It is always beneficial for a patient to have extensive knowledge of their medical condition and to discuss their options and concerns with their medical doctor.

References for this article include: and WebMD