Stable angina is
Angina – stable; Angina – chronic; Angina pectoris
Causes, incidence, and risk factors
Your heart muscle is working all the time, so it needs a constant supply of oxygen. This oxygen is provided by the coronary arteries, which carry blood.
When the heart muscle has to work harder, it needs more oxygen. Symptoms of angina occur when the coronary arteries are narrowed or blocked by hardening of the arteries (
The most common cause of angina is
Stable angina is less serious than unstable angina, but it can be very painful or uncomfortable.
High blood pressure
High LDL cholesterol and low HDL cholesterol
Anything that makes the heart muscle need more oxygen can cause an angina attack in someone with heart disease, including:
Other causes of angina include:
Abnormal heart rhythms(usually ones that cause your heart to beat quickly)
Coronary artery spasm(also called Prinzmetal’s angina)
Heart valve disease
Symptoms of stable angina are most often predictable. This means that the same amount of exercise or activity may cause your angina to occur. Your angina should improve or go away when you stop or slow down the exercise.
The most common symptom is chest pain that occurs behind the breastbone or slightly to the left of it. The pain of stable angina usually begins slowly and gets worse over the next few minutes before going away.
The pain may feel like tightness, heavy pressure, squeezing, or crushing pain. It may spread to the:
Arm (usually the left)
Some people say the pain feels like gas or
Some patients (women, older adults, and people with diabetes) may have different symptoms, such as:
- Back, arm, or neck pain
- Shortness of breath
The pain of stable angina usually:
- Occurs after activity or stress
- Lasts an average of 1 – 15 minutes
- Is relieved with rest or a medicine called nitroglycerin
Angina attacks can occur at any time during the day, but a higher number occur between 6 a.m. and noon.
Other symptoms of angina include:
A feeling of indigestion or heartburn
Dizziness or light-headedness
Nausea, vomiting, and sweating
Shortness of breath
Unexplained tiredness after activity (more common in women)
Signs and tests
Your doctor or nurse will examine you and measure your blood pressure. Tests that may be done include:
Coronary angiography Coronary risk profile(special blood tests) ECG
- Exercise tolerance test (stress test or treadmill test)
- Nuclear medicine (thallium)
- Stress echocardiogram
The options for treating angina include lifestyle changes, medications, and procedures such as coronary
You and your doctor should agree on
What medicines you should be taking to prevent angina
What activities are okay for you to do, and which ones are not
What medicines you should take when you have angina
What are the signs that your angina is getting worse
When you should call the doctor or 911
Nitroglycerin pills or spray may be used to stop chest pain.
Taking aspirin and clopidogrel (Plavix) or prasugrel (Effient) helps prevent blood clots from forming in your arteries, and reduces your risk of having a heart attack. Ask your doctor whether you should be taking these medications.
Your doctor may give you one or more medicines to help prevent you from having angina.
ACE inhibitors to lower blood pressure and protect your heart
Beta-blockers to lower heart rate, blood pressure, and oxygen use by the heart
Calcium channel blockers to relax arteries, lower blood pressure, and reduce strain on the heart
Nitrates to help prevent angina
Ranolazine (Ranexa) to treat chronic angina
NEVER STOP TAKING ANY OF THESE DRUGS ON YOUR OWN. Always talk to your doctor first. Stopping these drugs suddenly can make your angina worse or cause a heart attack. This is especially true of anti-clotting drugs (aspirin, clopidogrel, and prasugrel).
Your doctor may recommend a cardiac rehabilitation program to help improve your heart’s fitness.
Some people will be treated with medicines and will not need surgery to treat a blockage or narrowing. Others will need a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
Angioplasty and stent placement(also called percutaneous coronary intervention)
- Blockages that cannot be treated with angioplasty may need a
Stable angina usually improves with medication.
Calling your health care provider
Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your doctor.
Call 911 if your angina pain:
- Is not better 5 minutes after you take nitroglycerin
- Does not go away after three doses of nitroglycerin
- Is getting worse
- Returns after the nitroglycerin helped at first
Call your doctor if:
- You are having angina symptoms more often
- You are having angina when you are sitting (rest angina)
- You are feeling tired more often
- You are feeling faint or light-headed
- Your heart is beating very slowly (less than 60 beats a minute) or very fast (more than 120 beats a minute), or it is not steady
- You are having trouble taking your heart medicines
- You have any other unusual symptoms
Seek medical help right away if a person with angina loses consciousness.
A risk factor is something about you that increases your chance of getting a disease or having a certain health condition.
Some risk factors for heart disease you cannot change, but some you can.
Related:Angina – what to ask your doctor , Heart attack – what to ask your doctor, Angina – when you have chest pain, Angina – discharge, Chest pain, Angina, Coronary heart disease, Stress and anxiety, High blood cholesterol levels, Diabetes, Overweight, Coronary artery spasm, Heart Failure Overview, Arrhythmias, Anemia, Ventricular assist device