Angina & Chest Pain
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Angina is a type of chest pain resulting from reduced blood flow to your heart. It typically feels like a heavy or crushing pain in the chest that can spread to the arms, shoulders and back — similar to what is experienced during a heart attack.
Angina is not itself a disease, but rather a sign that an underlying heart disorder is restricting blood flow to your heart. For instance, it can be a symptom of coronary artery disease.
Our Approach to Treating Chest Pain
If you’re experiencing chest pain, our heart specialists carefully assess your cardiac health, investigate whether the chest discomfort is angina, and design a treatment plan focusing on relieving your chest pain as well as the underlying cause of your pain.
Your care team works together and with you to maximize your heart health and prevent further disease.
What Are the Types of Angina?
There are several different types of angina. The nature of your symptoms can therefore vary depending on the type of angina and its originating cause.
Stable angina, or angina pectoris, is the most common type of angina. It’s occurs when your coronary arteries are narrowed or blocked and insufficient oxygen is delivered to your heart during physical exertion. This type of angina signals an increased likelihood of heart attack, but it is often manageable.
Unstable angina, or acute coronary syndrome, occurs even without physical exertion and signals a more significant blockage in the coronary arteries that should be treated immediately.
Variant or Prinzmetal Angina
This rare type of angina results from spasms in the coronary arteries. Like unstable angina, pain in variant angina can also occur at rest, but the pain tends to occur in cycles and can disappear entirely for periods of time.
Microvascular angina is a type of stable angina resulting from disease in your microvasculature — the small blood vessels (as opposed to the large vessels) in your heart. It’s usually associated with systemic disease, such as high blood pressure and diabetes. This type of angina results in pain similar to a stable angina, but may also be accompanied by fatigue and shortness of breath.
How Is Stable Angina Treated?
Angina itself is not a disease, but it does signal an underlying heart condition.
If you have stable angina, we will usually perform a cardiac stress test. Your doctors will also likely advise you to take the heart disease prevention steps needed to live a healthy lifestyle and prevent the progression of heart disease.
In some cases, your doctors may give you one of several medications that can reduce the work and stress on your heart and control symptoms, including: nitrates, calcium channel blockers or beta blockers.
Your doctors will also regularly monitor your heart function to detect worsening disease as early as possible.
If you’re diagnosed with one of the rare types of angina caused by blockages in small vessels in your heart (microvascular angina), your doctor will likely prescribe medication to control the pain and prevent further attacks.
In addition, it will be important for you to adopt a healthy lifestyle, reducing risk factors for heart disease, and continue to work with you care team to ensure your angina is properly managed.
How is Unstable Angina Treated?
If you have unstable angina, it’s a medical urgency. Immediate intervention is required to restore normal blood flow to the heart.
In addition to being given medications that reduce the work and stress on your heart, your doctor will use cardiac catheterization to get a more detailed view of your coronary arteries. This procedure will help your care team determine the most effective treatment option for your specific condition.
If your unstable angina can’t be treated with just medications, a procedure or surgery may be required to treat your condition.
Coronary angioplasty, also known as percutaneous coronary intervention (PCI), is a common catheter-based procedure used to treat narrowing of the coronary arteries — allowing for better blood flow. During this procedure, a catheter is inserted into the affected arteries and a small balloon is inflated to widen the artery. Then, a small mesh tube, called a stent, is placed in the artery to ensure it remains open.
If several of your arteries are blocked, or the main artery of your heart is affected, coronary artery bypass surgery may be required. During this procedure, veins from the legs or other areas of the body are removed and grafted to the diseased coronary artery — allowing blood to bypass the blockage and continue to flow, unimpeded, to the heart.
If you’re diagnosed with one of the rare types of angina caused by spasms in the coronary arteries (variant or Prinzmetal angina), your doctor will likely prescribe medication to control the pain and prevent further attacks.
Chest Pain Unit
When it comes to chest pain, time matters. Several of our emergency rooms across Houston have dedicated Chest Pain Units to ensure that people arriving with atypical chest pain are immediately evaluated by a team of specialists.