Angina (Chest Pain)
Angina is usually caused by heart disease. A fatty substance called plaque builds up in the arteries, blocking blood flow to the heart muscle. This forces the heart to work with less oxygen, and that causes pain. You may also have blood clots in the arteries of your heart, which can cause heart attacks.
Other less common causes of chest pain include:
- A blockage in a major artery of the lungs (pulmonary embolism)
- An enlarged or thickened heart (hypertrophic cardiomyopathy)
- Narrowing of the valve in the main part of the heart (aortic stenosis)
- Swelling of the sac around the heart (pericarditis)
- Tearing in the wall of the aorta, the largest artery in your body (aortic dissection)
Chest pain is the symptom, but it affects people differently. You may feel:
- Feeling of fullness in the chest
You are likely to have pain behind your breastbone, but it can spread to your shoulders, arms, neck, throat, jaw, or back.
It's possible to mistake an aching or burning for heartburn or gas.
Men often feel pain in their chest, neck, and shoulders. Women may feel discomfort in their belly, neck, jaw, throat or back. You may also have shortness of breath, sweating, or dizziness.
One study found women were more likely to use the words "pressing" or "crushing" to describe the feeling.
Stable angina often gets better with rest. Unstable angina may not -- and could get worse.
Getting a Diagnosis
If you've been having chest pain, it's important to see your doctor, even if it goes away.
Your doctor will want to know:
- How have you been feeling?
- Where have you had pain?
- How strong would you say it was?
- How long did it last?
- What were you doing when it started?
- Did it come back?
- Have you felt this before?
- When did you begin having chest pain?
- Have you ever had a heart attack or heart surgery?
- Does anyone in your family have heart disease?
- Do you have any other medical conditions?
Your doctor may recommend these tests:
- Exercise stress test. You run on a treadmill or pedal a stationary bike while the doctor checks your heart rate, blood pressure, symptoms, and changes in your heart's rhythm.
- Electrocardiogram (EKG). It measures electrical signals from your heart to show how it's beating. Health workers attach small metal discs or stickers called electrodes to your chest, arms, and legs. With each heartbeat, an electric signal records how it’s working. The test only takes a few minutes, and it's painless. You can get an EKG at a doctor's office or the hospital.
- Coronary angiography. A thin tube called a catheter is threaded through a large blood vessel, usually one in your groin or wrist. The doctor injects dye through the tube, which travels to the arteries of your heart. As the dye moves, X-rays show how well your blood is flowing. X-rays use low doses of radiation to make images of the heart. You usually get these tests at a hospital and have to schedule it ahead of time. You may get a mild medicine to calm you beforehand.
- Computed tomography angiography. This test also checks how well blood flows through the arteries to your heart. You'll first get an injection of dye through a vein. Then X-rays are taken from different angles to create a three-dimensional image of your heart. Each scan takes just a few seconds and is painless. It can be done at a hospital or an outpatient clinic.
You may also have blood tests to check for fat, cholesterol, sugar, and proteins that put you at higher risk for heart disease.