Angina symptoms usually first appears during physical activity or emotional distress, both of which make the heart work harder and need more oxygen. But if the reduced blood flow is severe enough, angina can occur when a person is at rest.
When angina occurs it usually lasts only a few moments and goes away with rest. Sometimes it is worse when a person is active after having eaten. It is usually worse in cold weather or when moving from a warm room to a cold one. Sometimes experiencing a strong emotion while resting (or having a bad dream) can trigger it.
Typically, a person will feel pain or an ache or a sensation of pressure just beneath the breastbone. Many people describe the feel as discomfort or heaviness rather than pain. The ache or pressure might also be felt in either shoulder or down the inside of the arms, the back or in the throat, jaw or teeth.
The symptoms of angina that are felt by older people or by women may be different and easily misdiagnosed. Pain may be felt in the stomach area, especially after a meal. It may resemble indigestion.
Causes and Risk Factors
Fatty deposits in the arteries that feed the heart or sometimes because of other abnormalities that interfere with the flow of blood to the heart muscle are the main causes. Not everyone with coronary artery disease has angina.
Angina can also be caused by severe anemia - a condition in which the body has fewer red blood cells or less hemoglobin, which carries oxygen. Rarer causes of angina are severe high blood pressure, a narrowing of the aortic valve (aortic valve stenosis), leakage from the aortic valve, thickening of the walls of the ventricles. All of these factors make the heart work harder and increase its need for oxygen. Abnormalities of the aortic valve may also reduce the blood flow through the arteries of the heart. The openings for these arteries are just beyond the aorta.