The American Heart Association defines angina pectoris or angina, as a set of symptoms such as chest pain or discomfort caused by reduced blood flow to the heart.

According to the AHA, angina is not a disease in itself but a symptom of a disease or condition – usually coronary heart disease, which the AHA cites as one of the greatest health risks faced today. When the heart receives insufficient blood for its tissues to function properly, angina pain is triggered, which the AHA states is usually due to narrowing or blocking of the coronary arteries (ischemia). The AHA states this often makes angina a precursor to a heart attack.

Angina may exist in both stable and unstable forms, according to the Centers for Disease Control and Prevention. Stable angina/angina pectoris is the common type most often discussed; 4.4 percent of people in the United States responding to the Behavioral Risk Factor Surveillance System Survey have experienced it. According to the AHA, stable angina usually occurs when the heart must work harder, usually during physical exertion. It’s usually short in duration (five minutes or less) and may be relieved by medication. Although it may start out as chest pain, the pain may radiate to arms, back or other areas.

According to the CDC, unstable angina differs from stable angina in that it often occurs while resting or sleeping or when there is very little physical exertion. It may come as a surprise and last longer than stable angina. Rest and medicine may not relieve it, and it may get worse and lead to heart attack. They list angina as a major symptom of coronary heart disease, one of the greatest health risks faced today, which according to CDC statistics, is responsible for about one-infive deaths in the United States.

Dr. Ray D. Smith is a boardcertified cardiologist with Ark-La-Tex Cardiology in Shreveport. Smith said, “Typically, angina is a pressure-like sensation across the chest region. It can radiate to the neck, arm or back. It most often occurs with physical activity and is relieved with rest. It is often a sign of a blockage in one of the heart arteries.

“The first thing to do is rule out a blocked heart artery as the cause of the angina. This is usually accomplished with a noninvasive test known as a stress test. If the stress test suggests a blocked artery then the blockage can be treated with a catheter procedure known as angioplasty. This involves placing a tiny balloon across the blockage and expanding the balloon to relieve the occlusion. A tubelike structure called a stent is then placed and left in the artery to keep it open. This will eliminate the angina feeling.”

The Mayo Clinic lists the following risk factors, which increase your risk of coronary artery disease and angina:

• Tobacco use – all forms of tobacco may cause damage to the interior walls of arteries and allow deposits of cholesterol to collect and block blood flow.

• Diabetes speeds up atherosclerosis and increases cholesterol levels, increasing the risk of CAD and angina.

• High blood pressure accelerates hardening of the arteries, damaging them over time.

• High blood cholesterol or triglyceride levels – these may narrow arteries throughout one’s body, increasing resistance to pumping and lead to blockages.

• Family history of heart disease.

• Age – men over 45 and women over 55 have a significantly greater risk.

• Inactive lifestyle – a lack of exercise contributes to high cholesterol, high blood pressure, Type 2 diabetes and obesity.

• Obesity is associated with high blood cholesterol levels, high blood pressure and diabetes. The extra tissue requires the heart to work harder to supply it with blood.

• Stress increases the risk of angina and heart attacks and may raise blood pressure. Stress hormones can narrow the arteries.

The National Heart, Lung and Blood Institute suggests these healthy lifestyle changes to help prevent angina and heart disease:

• Quit smoking and avoid secondhand smoke; • Avoid angina triggers – stress, anger, strenuous activities; • Follow a healthy diet; • Be physically active; • Maintain a healthy weight; and • Learn ways to handle stress and relax. Smith said, “Angina can be a warning sign of an impending heart attack. It should never be ignored even if the pain goes away with rest.”