What is Angina Pectoris (Chest Pain)?
Angina, or angina pectoris, is the most well-known medical term for chest pain. It is not a disease itself but rather a symptom, specifically referring to discomfort that occurs when your heart muscle isn't getting enough oxygen-rich blood. This happens when arteries that carry blood to the heart become narrowed or blocked by plaque, a condition known as coronary artery disease (CAD). The resulting pain can be a mild, aching discomfort or a severe, crushing sensation.
Describing Angina Pain
Angina is often described using different sensations, which can provide clues to its cause. Common descriptions include:
- Pressure: A heavy feeling, as if an elephant is sitting on your chest.
- Squeezing or Tightness: A constricting sensation in the chest area.
- Burning: A sensation similar to heartburn or indigestion.
- Heaviness: A feeling of weight on the chest, especially when lying down.
The pain can also radiate to other parts of the body, including the neck, jaw, arms (especially the left), shoulder, and back. It is crucial to pay attention to these accompanying symptoms, as they can help a healthcare professional determine the cause.
Types of Angina
Not all angina is the same. The different types provide insight into the severity and underlying issue.
- Stable Angina: The most common form, this chest pain typically occurs during physical exertion or emotional stress and has a predictable pattern. It usually lasts only a few minutes and is relieved by rest or medication, such as nitroglycerin.
- Unstable Angina: A more serious and unpredictable type of chest pain, unstable angina can occur at rest, without a clear trigger, or be more severe or frequent than a person's typical stable angina. It does not respond well to rest or medication and requires immediate medical attention, as it may signal a heart attack.
- Variant Angina (Prinzmetal's Angina): This rare type is caused by a spasm in the heart's arteries, which temporarily reduces blood flow. It typically occurs at rest, often at night or in the early morning.
- Microvascular Angina: This type involves issues with the smallest blood vessels in the heart, leading to chest pain that can be more severe and last longer than other types. It's more common in women and can be triggered by stress or daily activities.
Non-Cardiac Causes of Chest Pain
While angina is a critical concern, many other conditions can cause chest pain. It's often difficult for an individual to distinguish between cardiac and non-cardiac causes without a professional medical evaluation.
Gastrointestinal Issues
- Gastroesophageal Reflux Disease (GERD): Acid reflux can cause a burning sensation (heartburn) that mimics cardiac chest pain.
- Esophageal Spasms: These can cause chest pain similar to a heart attack.
- Peptic Ulcers: Sores in the stomach lining can lead to pain that may be mistaken for heart problems.
Musculoskeletal Problems
- Costochondritis: Inflammation of the cartilage connecting a rib to the breastbone can cause sharp, localized chest pain that may worsen with movement.
- Muscle Strain: Strenuous exercise or heavy lifting can cause a strain in the chest muscles, leading to discomfort.
- Injured Ribs: A bruised or broken rib can cause significant, localized pain.
Lung-Related Conditions
- Pleurisy: Inflammation of the lung lining can cause sharp chest pain, especially with deep breathing or coughing.
- Pulmonary Embolism: A blood clot in the lung can cause sudden, sharp chest pain and shortness of breath. This is a medical emergency.
- Pneumonia: A lung infection can cause a cough, fever, and chest pain.
Other Causes
- Anxiety and Panic Attacks: These can cause chest tightness, a racing heart, and shortness of breath that feels very similar to a heart attack.
- Pericarditis: Inflammation of the sac surrounding the heart, causing sharp pain that worsens when lying down or breathing deeply.
Comparing Cardiac vs. Non-Cardiac Chest Pain
| Feature | Cardiac Chest Pain (Angina) | Non-Cardiac Chest Pain |
|---|---|---|
| Sensation | Pressure, squeezing, heaviness, tightness | Sharp, stabbing, or burning |
| Location | Central or left-sided chest, can radiate to arms, neck, jaw, back | Can be anywhere in the chest; often localized |
| Duration | Lasts more than a few minutes; may come and go | Can be brief (seconds), or persistent for hours/days |
| Triggers | Exertion, heavy meals, emotional stress, cold weather | Specific movements, posture changes, eating |
| Relief | Relieved by rest or nitroglycerin (stable angina) | Can improve with antacids, rest, or changing position |
| Accompanying Symptoms | Shortness of breath, sweating, nausea, dizziness | Difficulty swallowing, sour taste, cough, fever (depending on cause) |
When to Seek Medical Attention for Chest Pain
Given the potential for serious health issues, it's always best to be cautious with any new or severe chest pain. Call emergency services immediately if you experience:
- Sudden, crushing, or severe chest pain.
- Pain that spreads to your jaw, left arm, or back.
- Accompanying symptoms like shortness of breath, cold sweats, dizziness, or nausea.
- Chest pain that lasts for more than a few minutes and isn't relieved by rest.
For less severe or recurring pain that fits the pattern of non-cardiac causes, a visit to a primary care provider or urgent care can be appropriate. However, for any new or concerning symptoms, especially with existing risk factors for heart disease, an emergency room visit is the safest option.
Diagnosis and Treatment
Diagnosing the cause of chest pain is a critical process involving a medical history review, physical exam, and various tests.
Diagnostic Tools
- Electrocardiogram (ECG or EKG): Records the heart's electrical activity to check for signs of a heart attack or other cardiac issues.
- Blood Tests: Measures levels of certain proteins that leak into the blood when the heart is damaged.
- Chest X-ray: Provides images of the lungs, heart, and major blood vessels to check for problems like pneumonia or a collapsed lung.
- Stress Test: Monitors heart activity during exercise to see how the heart responds to exertion.
- CT Angiogram: Uses powerful X-rays and dye to create detailed images of the heart's arteries.
Treatment Options
Treatment for chest pain depends entirely on the underlying cause. For cardiac-related pain, treatments range from lifestyle modifications and medication to surgical procedures.
- Medications: Prescriptions may include nitroglycerin to widen blood vessels, beta-blockers to slow the heart rate, or aspirin to prevent blood clots.
- Angioplasty and Stenting: A minimally invasive procedure to open blocked arteries by inserting a balloon and a small mesh tube (stent).
- Coronary Artery Bypass Surgery: Creates new routes for blood flow around severely blocked or narrowed arteries.
For non-cardiac causes, treatment might involve antacids for GERD, anti-inflammatory medications for costochondritis, or addressing anxiety-related issues.
Conclusion
While many people associate chest pain with heart attacks, the term can refer to many conditions, both cardiac and non-cardiac. The specific medical term for heart-related chest pain is angina pectoris, a critical symptom of reduced blood flow to the heart muscle. It is essential to recognize the characteristics of your pain and associated symptoms. Because it's difficult to be certain of the cause without a medical evaluation, any unexplained or severe chest pain should always be evaluated by a healthcare professional immediately to rule out serious, life-threatening conditions. Understanding the nature of chest pain can empower individuals to seek timely care and make informed health decisions.
