John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Daniel Lee Kulick, MD, FACC, FSCAI
Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- Angina facts
- Introduction to angina
- What is angina and what are the symptoms of angina?
- What causes angina?
- What are other causes of chest pain?
- Why is it important to establish the diagnosis of angina?
- How is angina diagnosed?
- What are the treatment options for angina patients?
- Angina medications
- Angioplasty and coronary artery bypass surgery
- What's new in the evaluation of angina?
- What's new in the treatment of angina and heart attacks?
- Patient Comments: Angina - Share Your Experience
- Patient Comments: Angina - Symptoms
- Patient Comments: Angina - Causes
- Patient Comments: Angina - Other Chest Pain Experience
- Patient Comments: Angina - Diagnosis
- Find a local Cardiologist in your town
- Angina is one of many causes of chest pain.
- Angina is chest pain that is a result of inadequate oxygen supply to the heart muscle.
- Angina can be caused by coronary artery disease or spasm of the coronary arteries.
- Electrocardiogram (ECG or EKG), exercise stress test, stress echocardiography, stress thallium, and cardiac catheterization are important in the diagnosis of angina.
- Treatment of angina includes rest, medications, angioplasty, and/or coronary artery bypass surgery.
Introduction to angina
Angina is one of the serious causes of chest pain. "Angina" is an abbreviation of angina pectoris, a Latin term for "squeezing of the chest." Chest pain is a common symptom caused by many different conditions. Some causes require prompt medical attention, such as angina, heart attack, blood clots in the lungs, or tearing of the aorta. Other causes of chest pain that may not require immediate medical intervention include spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. An accurate diagnosis is important in providing proper treatment to patients with chest pain or acute coronary syndrome.
What is angina, and what are the symptoms of angina?
Angina is chest discomfort that occurs when there is decreased blood oxygen supply to an area of the heart muscle. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis.
Angina is usually felt as:
- squeezing, or
- aching across the chest, particularly behind the breastbone.
This pain often radiates to the neck, jaw, arms, back, or even the teeth.
Patients may also suffer:
- cramping, and
- shortness of breath.
Angina usually occurs during exertion, severe emotional stress, or after a heavy meal, when the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina typically lasts from 1 to 15 minutes and is relieved by rest or by placing a nitroglycerin tablet under the tongue, which relaxes the blood vessels and lowers blood pressure. Both rest and nitroglycerin decrease the heart muscles demand for oxygen, relieving angina.
Angina is classified in one of two types: 1) stable angina or 2) unstable angina.
Stable angina is the most common type of angina, and what most people mean when they refer to angina. People with stable angina have angina symptoms on a regular basis and the symptoms are somewhat predictable (for example, walking up a flight of steps causes chest pain). For most patients, symptoms occur during exertion and commonly last less than five minutes. They are relieved by rest or medication, such as nitroglycerin under the tongue. Stable angina is one of many causes of chronic chest pain.
Unstable angina is less common but more serious. The symptoms are more severe and less predictable than the pattern of stable angina. Pain is more frequent, lasts longer, occurs at rest, and is not relieved by nitroglycerin under the tongue (or the patient needs to use more nitroglycerin than usual). Unstable angina is not the same as a heart attack, but warrants an immediate visit to your physician or hospital emergency department as further cardiac testing is urgently needed. Unstable angina is often a precursor to a heart attack.
Next: What causes angina?
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