Key Differences Between Angina and Heart Attacks Explained

Understanding Angina and Heart Attacks

Chest pain can be scary, especially when you don't know what's causing it. Two common causes of chest pain are angina and heart attacks. While they share some similarities, there are key differences between angina and heart attacks in terms of symptoms, causes, diagnosis, and treatment.

Defining Angina

Angina occurs when there is reduced blood flow to the heart. Often described as chest pain or chest discomfort, angina happens when the heart's demand for oxygen increases but the oxygen supply via the coronary arteries is temporarily blocked or reduced. There are a few types of angina:

• Stable angina: Predictable pattern of chest pain that is caused by routine activity
• Unstable angina: New, changing, or worsening chest pain patterns
• Variant (Prinzmetal's) angina: Caused by spasms in the coronary arteries

While uncomfortable or distressing, angina itself does not damage the heart muscle. However, the underlying disease process causing the decreased blood flow does increase one's risk for having a heart attack.

Understanding Heart Attacks

A heart attack, also called a myocardial infarction, happens when blood flow to part of the heart is completely blocked causing damage to the heart muscle. This blockage is often the result of a coronary artery that has become progressively narrowed by the buildup of various substances including cholesterol and cellular waste products called plaque.

A heart attack is very serious because the loss of blood flow permanently damages the heart. The longer the heart goes without oxygen, the greater the damage. That's why quick treatment to restore blood flow is vital for preventing complications and death.

Key Differences Between Angina and Heart Attacks

While both cause chest pain, angia and heart attacks have some distinct differences:

Symptoms

Angina:

• Chest pain or discomfort that feels like pressure or squeezing
• Sensation may spread to shoulders, arms, neck, jaw, or back
• Triggered by exertion or stress and goes away with rest
• Typically follows a consistent pattern for each person

Heart Attack:

• Persistent chest pain that doesn't ease up with rest
• Pain that radiates to other areas like the arm, jaw, shoulders, back, and stomach
• Shortness of breath, sweating, nausea or vomiting, lightheadedness
• Not necessarily triggered by exertion

Causes

Angina: Temporary blockage that reduces blood flow
Heart Attack: Complete, prolonged blockage that stops blood flow

Complications

Angina: Does NOT damage the heart
Heart Attack: Permanently damages heart muscle tissue

Diagnosis

Angina - Stress test, EKG, blood work, imaging tests
Heart Attack - EKG, blood tests of heart muscle proteins, imaging of heart arteries

Treatment

Angina - Medications to improve blood flow, stents to improve artery opening, counseling on diet, exercise, and lifestyle management

Heart Attack - Emergency procedures to open blocked artery and limit heart damage. This may involve medications, stents, or bypass surgery. Cardiac rehabilitation and lifestyle changes for recovery.

Risk Factors

Angina and heart attacks share similar risk factors since they both involve issues with the heart and circulatory system. Understanding the risk factors can help guide prevention strategies.

Shared Risk Factors

• Smoking - Damages blood vessels and increases clotting
• High cholesterol - Leads to plaque buildup in arteries
• High blood pressure - Puts extra strain on the heart
• Diabetes/prediabetes - Increases inflammation and artery damage
• Obesity - Linked to high blood pressure, high cholesterol, and diabetes
• Physical inactivity - Contributes to other risk factors
• Family history - Genetic tendency toward heart disease
• Older age - Arteries grow narrower over decades

Unique Risk Factors

In addition to the shared risk factors above, some unique risk factors make a person more prone specifically to heart attacks. These include:

• Prior heart attack - Scarring and reduced heart function up risk
• Abnormal heart rhythms like atrial fibrillation
• Heart defects from birth that affect blood flow
• History of diseases like rheumatoid arthritis or lupus that increase inflammation
• Severe emotional stress which can alter heart rhythms
• Preeclampsia and gestational diabetes in pregnancy

Prevention

Many heart attacks can be prevented by managing risk factors. Likewise, preventing further narrowing of the heart arteries can help avoid episodes of angina. Key prevention tips include:

Heart Healthy Lifestyle

• Following an anti-inflammatory diet high in fruits, vegetables, and whole grains
• Exercising for 150 minutes per week of moderate activity
• Keeping blood pressure under 130/80 mmHg
• Reduce and manage stress levels
• Aim for 7-9 hours of quality sleep per night
• Limit alcohol to 1 or fewer drinks per day for women, 2 or fewer for men

Monitor Health Markers

• Get regular checkups to stay on top of blood pressure, cholesterol, and blood sugar numbers
• Discuss family history with your doctor about potential heart disease risk
• Call your doctor promptly about new or worsening chest discomfort

When to Seek Emergency Care

Chest pain should never be ignored or brushed off, as it may indicate a serious issue needing immediate emergency care. Call 911 or go to the nearest emergency room if you experience:

• Severe chest pressure or squeezing along with shortness of breath, sweating, nausea
• Sudden onset chest pain unlike previous stable angina patterns
• Chest pain that does not improve or goes away after 5 minutes of rest
• Chest pain symptoms that spread through your jaw, shoulders, back, or one or both arms

Quick recognition of a heart attack and activation of emergency response is critical to receive life-saving treatment within the shortest window of time possible. Always err on the side of caution if you think you might be having heart attack symptoms.

The Bottom Line

Angina differs from a heart attack in that it causes temporary chest pain from reduced blood flow rather than permanent damage from a complete lack of blood flow. However, the risk factors and disease processes that set the stage for angina also make someone more likely to have a heart attack in the future if preventive action is not taken.

Lifestyle changes and diligent monitoring of your cardiovascular health markers can help prevent further progression toward more serious outcomes. If in doubt about any troubling chest pain symptoms, promptly seek emergency care for assessment.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.