Causes
The most common cause of chest pain is coronary artery disease. Coronary artery disease is defined as the hardening and blockage of the coronary arteries. This occurs when an individual’s cholesterol levels are elevated over a long period of time and cholesterol continues to build up on the inside walls of the arteries. Cholesterol deposits blocked blood flow to the heart and then to the rest of the body. This build up within the coronary arteries is known as atherosclerosis. As the cholesterol builds and builds, it begins to block more and more blood flow thus increasing the oxygen and blood demand of the heart. When the oxygen and blood demand of the heart is increased and there is blockages within the arteries, the result is chest pain otherwise known as angina pectoris.
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Symptoms
For all the above different types of angina there are some commonalities in terms of the symptoms. Angina can be chest pain, chest tightness, chest heaviness, or chest discomfort. In many cases the quality of the pain is described as pressure, burning, tightness, fullness or squeezing. Often the pain is not only localized centrally and sub-sternal, but also radiates to either arm, neck, mandible (lower jaw), upper back or shoulder. Other symptoms associated with pain may include: nausea, fatigue, diaphoresis, dizziness/lightheadedness and shortness of breath. It is quite common for chest pain to be dismissed as acid reflux. Do not dismiss symptoms of indigestion if you are experiencing chest pain with it, because it has the potential to be a true cardiac event. Individuals may also experience epigastric abdominal pain and dismiss it as non-cardiac, when in reality it is their heart. If you experience any of these signs/symptoms, it is imperative that you speak with your healthcare provider immediately so that appropriate emergent medical care can be administered.
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In stable angina, the individual may experience the above symptoms, but there are distinguishing characteristics that allow for this diagnosis over unstable angina and prinzmetal’s angina. Patients with stable angina will notice the chest pain occurring during physical activity and lasting for less than or equal to 5 minutes. Stable angina is alleviated when the individual stops the activity and/or takes Nitroglycerin. In unstable angina, the chest pain occurs during any part of the day while the individual is active and/or while the individual is at rest. This type of angina lasts for less than or equal to 30 minutes and is not alleviated by rest. This type of angina is unstable and is not alleviated by Nitroglycerin in most cases.
Prinzmetal’s angina is defined as coronary artery vasospasm. This specific type of chest pain normally occurs at night or early in the morning. It can be quite severe, but only lasts a few seconds to few minutes and can also be relieved by Nitroglycerin.
