The Spectrum Of Heart Pain: From Angina To A Heart Attack

Blockages in the heart arteries generally occur gradually over many years. Symptoms from artery blockage are due to decreased oxygen to the heart. Blood carries oxygen to the heart, hence decreased blood flow is the main cause of the low oxygen. The length of time that the heart is deprived of oxygen determines the ultimate result. If the heart is deprived of oxygen for too long, the heart muscle may become permanently damaged.

The mildest form of heart pain is called angina. Angina is condition when a person has reversible symptoms due to low oxygen reaching the heart. The symptoms usually include chest pain and shortness of breath. Often, those who eventually have a heart attack first have angina for several months or even years, though this is not always true. Angina is usually brought on by exertion and is relieved by rest.

When the pattern of angina stays the same and is predictable, it's called stable angina. For example, some people get chest pain or angina, every time they try to walk more than two flights of stairs, but the symptoms go away when they stop to catch their breath. By definition, stable angina is reversible and goes away when the person stops exerting. Some people simply have to rest, while others may need to take a drug called nitroglycerin to relieve their symptoms. In either case, symptoms usually only last 1 to 5 minutes and almost always less than 20 minutes. Angina does not result in any immediate, identifiable heart damage, though it can weaken the heart over time.

The other end of the spectrum of heart pain is a heart attack or myocardial infarction. The symptoms of a heart attack are similar to angina, but are usually more severe and usually the symptoms don't go when a person rests. The symptoms may last for an hour or more if quick treatment is not received. Heart attack or myocardial infarction results in permanent damage or death to a part of the heart. This generally occurs when a heart artery becomes completely blocked. Heart attacks can result in passing out, failure of the heart to pump enough blood (called cardiac failure), irregular heartbeats or sudden death. These symptoms are not usually seen after angina.

In between stable angina and heart attacks is a condition called unstable angina. People with unstable angina are at high risk of having a heart attack. People with angina that develop a change in their regular pattern of angina are said to have become unstable. When angina symptoms are seen at rest or do not go away in 5 to 20 minutes after stopping exertion, people are either having unstable angina or a heart attack. Unstable angina is diagnosed if the heart muscle has not become permanently damaged as in heart attack or myocardial infarction. However, those with unstable angina can easily progress to a heart attack.

Anyone with a first episode of chest pain or a change in his or her angina symptoms should go immediately to the nearest hospital emergency room. Immediate treatment for angina, unstable angina and heart attacks can reduce the risk of disability or death. Sometimes, heart attacks can be "reversed" with special medications or procedures, when given immediately.

Chest pain is a symptom that should never be ignored, even if it goes away, especially in people with one or more risk factors for heart artery blockage. Early evaluation and treatment of chest pain may save a person's life. And if the pain turns out to be not related to the heart, it will be one less thing to worry about!

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