angina
Meaning of angina: Chest discomfort that arrives on exertion and leaves at rest is the heart complaining about a supply line that has narrowed.
Definition of angina
Angina is chest discomfort that occurs when the heart muscle receives less blood than its workload demands. It is usually described as pressure, tightness or a heavy band across the chest rather than a sharp pain, and it may spread to the jaw, neck, shoulder or arm. It is a symptom of an underlying circulation problem, not a disease in itself.
Why does it come and go?
The heart adjusts its own blood supply to its workload. A narrowed artery can still deliver enough for a body at rest, but it cannot widen to meet the extra demand of climbing stairs, hurrying, cold air or a heavy meal. Supply falls short, the muscle works in a state of ischemia, and the discomfort appears. Stopping lowers demand again, supply catches up, and the sensation fades within a few minutes. That reproducible link to effort is the most recognizable feature of the symptom, which is why the pattern carries more information than the severity when the story is taken.
What are the patterns?
| Pattern | When it occurs | What it reflects |
|---|---|---|
| Stable | Predictably on exertion, eases with rest | A fixed narrowing that limits extra flow |
| Unstable | At rest, newly begun, or provoked more easily than before | A deposit that has become unstable |
| Variant | Often at rest and at night | Spasm of the artery rather than a fixed narrowing |
| Microvascular | On exertion, with unobstructed main arteries | Disease of the smallest vessels |
Stable angina is the most familiar of the four and usually accompanies coronary artery disease built up over years. Variant angina behaves oddly by comparison, since the artery may look smooth and open between attacks and clamps down on its own. Microvascular angina accounts for many people who have convincing symptoms alongside main arteries that appear normal, and for a long time those symptoms were dismissed on that basis.
Why does a change in the pattern matter?
Because it signals that the deposit has changed rather than that the person has grown less fit. Discomfort arriving at rest, waking someone at night, lasting longer, or provoked by less effort than the week before is classed as unstable, and unstable angina is grouped with heart attack under the heading of acute coronary syndrome. The two share a mechanism, a cracked deposit with clot forming on it, and differ in whether muscle has actually died. That grouping exists because the situation is time-critical: the same process can close the artery completely.
Also known as
Used in a sentence
The patient described exertional angina that settled within minutes of stopping.
Good to know
Angina names a symptom rather than a diagnosis, and the older use of the word for a strangling throat condition survives in names such as Ludwig angina, which has nothing to do with the heart.
Word origin
Where “angina” comes from
Angina comes from the Latin angere, to choke or strangle, describing the constricting quality of the sensation. The fuller name angina pectoris adds pectoris, of the chest.