I find that a lot of my patients often confuse the Cardiology term “angina” with “heart attack” or “myocardial infarction”.
Angina is a symptom of ischemia, which is the lack of adequate blood flow to the heart muscle.
If you think of the heart as a muscle, which it is; then a cramp, it is similar to a cramp in your leg – muscle cramps because of the imbalance of electrolytes or from dehydration, fatigue, or overuse – the bottom line is that lack in your electrolytes or hydration is a
common source of muscle cramps, and your heart is no different. The heart also cramps when the supply of oxygen does not meet the demand for the cells of the constantly beating heart muscle.
We refer to angina as “stable” when it occurs to an increase in energy demand such as physical exertion. It also indicates that it is fairly predictable. Stable angina is usually reproducible during exercise stress testing. When angina is suspected and/or diagnosed
on a stress test, an angiogram or cardiac catheterization is needed to assess the circulatory system of the heart. If an invasive procedure like a stent or cardiac bypass is not recommended, or is deferred for some reason, then medication is prescribed to keep the
heart below the anginal threshold, the pulse rate and blood pressure with which the symptoms of ischemia occur. You should know that the higher the rate and higher the blood pressure needed to respond to exertion, places extra oxygen demand on the heart.
Stable angina is relieved with rest. Some people may take nitroglycerin under their tongue to assist the heart.
Unstable angina is unpredictable. The unstable angina symptoms are the same as those for stable, but unstable can happen when you are resting or when you are emotionally upset. It is a medical emergency.
Typically these include chest pain, discomfort, pressure, shortness of breath, or fatigue. Most typical are pain, pressure or discomfort in the jaw or teeth, in the arms including the elbow and wrist, or indigestion. Some folks describe a feeling that they “just couldn’t burp” the way they wanted to.
Angina Versus Heart Attack:
The big difference between an anginal attack and a heart attack is that angina is a warning, but it is temporary and there is no permanent muscle damage to the heart. Rest or nitroglycerin will relieve the ischemia and so the anginal symptoms. Sadly, even a
person with no prior history of angina can have a heart attack. Myocardial infarction is the term for heart attack, which is also referred to as a coronary thrombosis. So, the “Good News” is that someone with angina has not damaged the heart. The “Bad News” is
that these folks who have angina do have heart disease and they need to see a cardiologist regularly to evaluate and track their heart disease as well as learn their treatment options.
DEAN R. SILVER, M.D.