• Chest Pain or Angina

     
     
     
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    Chest pain, arm tingling, shortness of breath, being more tired and fatigued with usual activities - all may be signs that blood flow to your heart is becoming restricted or blocked.  

    The cause may be a build-up of fatty deposits, or plaque (pronounced "plak"), inside your arteries - the blood vessels that carry oxygen and nutrients from the heart to your body.  When arteries become partly or completely blocked with plaque, atherosclerosis (pronounced ath-ERO-skla-RO-sis) occurs.  It may be called hardening of the arteries.

    When plaque builds up in arteries, it narrows the channel through which blood flows.  When blood flow is restricted or completely blocked, the oxygen and nutrients your muscles and organs need to function are also restricted.  And when muscles or the heart that are deprived of oxygen are placed under additional stress, such as during exertion, you may feel discomfort.  

    So when you feel chest pain or discomfort, which your doctor may call angina or angina pectoris, it may be because the heart muscle is not receiving sufficient blood flow.  

    Your doctor may describe your chest pain as "Unstable" or "stable" angina.  

    Unstable Angina

    With unstable angina, also referred to as Acute Coronary Syndrome, chest pain and other symptoms of cardiovascular disease are worsening, becoming more frequent or occurring with less exertion.

    If this is your situation, your doctor may adjust drug therapy to stabilize symptoms or may pursue other forms of testing and monitoring.

    Depending on the ongoing evaluation, you may be sent to the catheterization lab for a heart catheterization and ultimately an angioplasty and/or a stent, procedures to open blockages in your arteries. Alternatively, if the blockages are more extensive or severe, you may be referred to a surgeon for coronary artery bypass surgery.

    Stable Angina

    With stable angina, you have "predictable" symptoms - symptoms to which you have become accustomed. When you engage in physical activity at various levels of intensity, you have come to expect shortness of breath (more common in women than men), chest pressure, neck, jaw or shoulder pain. When you stop the activity, symptoms also cease.

    If you have stable angina, your care team will:

    • Ask you questions and listen carefully to your answers to understand your:
      • Medical history
      • Current symptoms and other current health conditions, such as diabetes and hypertension.

  • Additional Information on Chest Pain (Angina)

    Types of Chest Pain

    In general, heart-related chest pain feels different from other sources of chest pain, but if there is any doubt, and especially if the chest pain begins suddenly and is ongoing, call 9-1-1 to be taken to the hospital. Driving yourself is not safe: if your condition worsens, you could cause a car accident and injure yourself or others. Additionally, if the medical response team is with you on the way to the hospital, they can treat you sooner, which may save your life.

    Heart-Related Causes of Chest Pain

    The heart and its blood vessels can be the source of chest pain. Because the heart is a complex organ, many different problems can be at the root of chest pain, but usually it comes down to supply and demand. Chest pain occurs when the plaque builds up in the blood vessels and decreases the flow of blood to the heart muscle.

    Non-Heart-Related Causes of Chest Pain

    The vast majority of chest pain seen by doctors is actually related to muscles, bones, or joints rather than the heart or lungs. It is often sharp pain, specific to one area (although not always), and may improve or worsen with deep breathing, turning, or arm movements. It may last several hours or weeks and is often easily reproducible. Sometimes, after giving it some thought, patients with this type of chest pain recall recent heavy lifting or other unusual physical activities that may have caused the pain.

    Treatment for Heart-Related Chest Pain

    If your chest pain is a symptom of a heart-related condition, you will be referred to a cardiologist for treatment. If your heart-related problem is urgent, you will be admitted to the hospital to be evaluated and treated by a cardiologist (heart specialist).

    Treatment for Non-Heart-Related Chest Pain

    If your heart or lungs are not causing your chest pain, you will likely need to see your primary care doctor to determine the cause of your chest pain.