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Angina (chest pain)

Chest pain, also called angina, is the most common symptom of coronary artery disease. The pain may have a distinct pattern. Angina can be described as:

  • A feeling of pressure, heaviness, weight, tightness, squeezing, discomfort, burning, or dull aching in the chest. People often put their fist to their                 chest when describing the pain.
  • Hard to pinpoint (you can't point to the exact location of the pain). Pressing on the chest wall does not cause the pain.

The chest pain of angina usually begins at a low level, then increases over several minutes to a peak. Angina that starts with an activity usually will decrease when the activity is stopped. Chest pain that begins suddenly or lasts only a few seconds is less likely to be angina.

Angina usually begins in the chest, but it can also start in or spread to different areas of the body, such as:

  • Down the left arm (most common site).
  • To the left shoulder.
  • To the neck or lower jaw.
  • To the mid-back.
  • Down the right arm.

Some people may feel tingling or numbness in their arm, hand, or jaw when they have angina.

Angina is often brought on by activities that make the heart work harder, because the heart needs more oxygen than can be delivered through the narrowed arteries. Some of these activities include:

  • Strenuous exercise (especially if you ordinarily do not exercise).
  • Use of cocaine or amphetamines.
  • Exposure to cold temperatures.
  • Sudden, intense emotions such as anger or fear.
  • Smoking.
  • Eating a heavy meal.

Many people have stable angina, which is predictable. It eases after they rest and take nitroglycerin, a medicine that opens blood vessels to improve blood flow. But if there is a change in the usual pattern of your angina, you may have unstable angina. In unstable angina, chest pain occurs at rest or with less and less exertion, may be more severe and last longer, or doesn't respond to nitroglycerin. Because unstable angina can progress to a heart attack, it requires medical attention right away.