Is Angina a Precursor to a Heart Attack?

Angina, or chest pain, is often the first symptom of heart disease. It serves as a precursor to a future heart attack and it’s also a sign that you’re currently having a heart attack.

Would it surprise you to learn that many people initially ignore angina? That’s because chest pain isn’t always an obvious, sharp, heart-related pain.

You could have mild chest pain that goes away or you might think that your pain is due to heartburn or a pulled muscle. But you should protect your health by having any type of chest pain evaluated by Dr. Laura Fernandes at Woodlands Heart and Vascular Institute.

Dr. Fernandes shares more about the different types of angina and when your chest pain demands emergency treatment.

Angina explained

Angina refers to chest pain that’s caused by a lack of blood flow to your heart. Though coronary artery disease (CAD) isn’t the only reason for angina, it’s the most common cause.

You develop CAD when cholesterol and other fats build up in the arteries carrying oxygen-rich blood throughout your heart. As cholesterol plaque enlarges over the years, it blocks blood flow, depriving the heart muscle tissue of vital oxygen.

Angina can persist for years, serving as an ongoing reminder that you have heart disease and signalling a higher risk of having a heart attack.

In some cases, however, you don’t develop angina as a precursor. Instead, you don’t have any symptoms until the blood flow is so severely blocked that you have a heart attack and angina at the same time.

Types of angina and heart attack concerns

You may develop one of three types of angina:

Stable angina

This is the type of angina that occurs due to blocked coronary arteries. The chest pain of stable angina is typically triggered by walking, climbing stairs, and other activities that demand more blood and oxygen.

Stable angina may cause other symptoms, including pressure or heaviness in your chest and pain in your jaw, neck, arms, and/or back.

Your chest pain and other symptoms are short-lived and improve when you rest or take nitrate medications, such as nitroglycerin tablets.

How do you know when stable angina may signal a heart attack? You should seek immediate medical care when your pain doesn’t improve or your symptoms are new or more severe.

Unstable angina

Unstable angina refers to sudden, unexpected chest pain that always needs emergency medical care. This pain doesn’t improve with rest or medication because it’s caused by a blood clot or a completely blocked coronary artery. Additionally, unstable angina can occur at any time; whether you’re exercising or resting.

Prinzmetal angina

This type of angina is rare, typically affects younger patients, and is caused by a spasm in the coronary arteries. 

The spasm is caused by:

Prinzmetal differs from the other types of angina because it occurs while you’re resting, usually during the night. The pain is severe, but it gets better with medication.

This type of angina may be a sign that you have a higher risk for heart attack or dangerous irregular heart rhythms such as atrial fibrillation. But you can usually keep it under control with medication and by avoiding triggers.

Coronary artery disease and risk for angina

One study reported that 8% of patients with CAD had daily or weekly episodes of angina and that 25% experienced angina about once a month. On the other hand, 67% didn’t have chest pain, so they didn’t have a red flag alerting them to their risk for a heart attack.

For this reason, we encourage you to schedule an appointment if you know you’re at risk for CAD or you’d like to have your risk assessed and get an initial evaluation.

The biggest risk factors for CAD are:

At the first sign of chest pain, or to learn if you’re at risk for angina and CAD, call our office in The Woodlands, Texas, or book an appointment online.

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