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Different Types of Angina

The most common type of angina is referred to as stable angina.  In this type, a predictable amount of activity or stress brings on an angina attack.  The severity and duration of the discomfort are more or less the same in each attack.  Symptoms are promptly relieved by rest or the drug, nitroglycerin.

Unstable angina refers to angina in which the pattern of symptoms changes.  It often indicates severe blockages in the coronary arteries.  Unstable angina may be a sign that a heart attack is likely to occur soon.

Variant (or Printzmetal's) angina is a rare type of angina that results from spasm of one of the large coronary arteries.  These attacks may be intense and long-lasting, and usually occur in the early morning hours, often awakening the patient from sleep.

Silent ischemia refers to ischemia that is not accompanied by symptoms.  It is usually detected by observing changes on the ECG during activity.  Patients with silent ischemia have the same risk of heart attack as those with symptoms of angina.

What is a Heart Attack?

Patients with angina are at risk of developing a heart attack.  A heart attack is the death of heart muscle brought on by the complete blockage of a diseased coronary artery by a blood clot.

In angina, the lack of oxygen (ischemia) to the heart muscle is temporary. In a heart attack, on the other hand, muscle damage is permanent.  The dead muscle turns into scar tissue as it heals.  A scarred heart may not pump as efficiently as a normal heart.

Symptoms of Angina

Because chest pain may be caused by conditions other than angina, it is important to know what angina feels like and what brings it on.

What Does Angina Feel Like?

Even though people experience angina differently, most describe their discomfort as a pressure, tightness, heaviness, or squeezing.  Some describe a burning sensation or "heartburn."  Still others report excessive breathlessness with exertion.

Angina typically is felt in the middle of the chest, behind the breastbone.  The pain or discomfort often spreads to other areas, especially the arm, shoulder, upper back, neck or jaw.  Sometimes, the discomfort is felt in one or more of these areas, without any painful sensation in the chest.