What is stable angina?
Angina is a type of chest pain that results from reduced blood flow to the heart. A lack of blood flow means your heart muscle isn’t getting enough oxygen. The pain is often triggered by physical activity or emotional stress.
Stable angina, also called angina pectoris, is the most common type of angina. Stable angina is a predictable pattern of chest pain. You can usually track the pattern based on what you’re doing when you feel the pain in your chest. Tracking stable angina can help you manage your symptoms more easily.
Unstable angina is another form of angina. It occurs suddenly and gets worse over time. It may eventually lead to a heart attack.
Though stable angina is less serious than unstable angina, it can be painful and uncomfortable. Both types of angina are usually signs of an underlying heart condition, so it’s important to see your doctor as soon as you have symptoms.
Stable angina occurs when the heart muscle doesn’t get the oxygen it needs to function properly. Your heart works harder when you exercise or experience emotional stress.
Certain factors, such as narrowing of the arteries (atherosclerosis), can prevent your heart from receiving more oxygen. Your arteries can become narrow and hard when plaque (a substance made of fat, cholesterol, calcium, and other substances) builds up inside the artery walls. Blood clots can also block your arteries and reduce the flow of oxygen-rich blood to the heart.
The painful sensation that occurs during an episode of stable angina is often described as pressure or fullness in the center of the chest. The pain can feel like a vice squeezing your chest or like a heavy weight resting on your chest. This pain may spread from your chest to your neck, arms, and shoulders.
During an episode of stable angina, you may also experience:
- shortness of breath
- profuse sweating
Stable angina usually happens after you’ve exerted yourself physically. The symptoms tend to be temporary, lasting up to 15 minutes in most cases. This is different from unstable angina, in which the pain can be continuous and more severe.
You can have an episode of stable angina at any time of day. However, you’re more likely to experience symptoms in the morning.
Risk factors for stable angina include:
- being overweight
- having a history of heart disease
- having high cholesterol or high blood pressure
- having diabetes
- not exercising
Large meals, vigorous physical workouts, and extremely hot or cold weather can also trigger stable angina in some cases.
Your doctor will ask you about your medical history and run tests to diagnose stable angina. Tests may include:
- electrocardiogram: measures the electrical activity in your heart and evaluates your heart rhythm
- angiography: a type of X-ray that allows your doctor to see your blood vessels and measure blood flow to your heart
These tests can determine if your heart is functioning properly and if any arteries are blocked.
You may also need to take a stress test. During a stress test, your doctor will monitor your heart rhythm and breathing while you exercise. This type of test can determine if physical activity triggers your symptoms.
In some cases, your doctor might run blood tests to measure your cholesterol and C-reactive protein (CRP) levels. High levels of CRP can increase your risk of developing heart disease.
Treatment for stable angina includes lifestyle changes, medication, and surgery. You can usually predict when the pain will occur, so reducing physical exertion can help manage your chest pain. Discuss your exercise routine and diet with your doctor to determine how you can adjust your lifestyle safely.
Certain lifestyle adjustments can help prevent future episodes of stable angina. These changes may include exercising regularly and eating a healthy diet of whole grains, fruits, and vegetables. You should also quit smoking if you’re a smoker.
These habits can also reduce your risk of developing chronic (long-term) diseases, such as diabetes, high cholesterol, and high blood pressure. These conditions can affect stable angina and may eventually lead to heart disease.
A medication called nitroglycerin effectively relieves pain associated with stable angina. Your doctor will tell you how much nitroglycerin to take when you have an episode of angina.
You might need to take other medications to manage underlying conditions that contribute to stable angina, such as high blood pressure, high cholesterol, or diabetes. Tell your doctor if you have any of these conditions. Your doctor may prescribe certain medications that can help stabilize your blood pressure, cholesterol, and glucose levels. This will lower your risk of experiencing more episodes of angina.
Your doctor may also prescribe you blood-thinning medication to prevent blood clots, a contributing factor in stable angina.
A minimally invasive procedure called angioplasty is often used to treat stable angina. During this procedure, a surgeon places a small balloon inside your artery. The balloon is inflated to widen the artery, and then a stent(tiny wire mesh coil) is inserted. The stent is permanently placed in your artery to keep the passageway open.
Blocked arteries may need to be surgically repaired to prevent chest pain. Open-heart surgery may be done to perform a coronary artery bypass graft. This may be necessary for people with coronary heart disease.
The outlook for people with stable angina is generally good. The condition often improves with medication. Making certain lifestyle changes can also keep your symptoms from getting worse. This includes:
- maintaining a healthy weight
- exercising regularly
- avoiding smoking
- eating a balanced diet
You may continue to struggle with chest pain if you’re unable to transition to a healthier lifestyle. You also might be at an increased risk for other types of heart disease. Possible complications of stable angina include heart attack, sudden death caused by abnormal heart rhythms, and unstable angina. These complications can develop if stable angina is left untreated.
It’s important to call your doctor as soon as you experience signs of stable angina.