Is It a Heart Attack or Angina?

Medically Reviewed by James Beckerman, MD, FACC on December 03, 2013

It's dramatic when an actor on TV or the movies has a heart attack. But in real life, symptoms can be more subtle and hard to identify. And because heart attack and angina symptoms are so similar, it may be hard to tell what's going on.

But if you know the differences -- and the reasons behind them -- you'll learn to get treatment sooner, and maybe live longer, too.

Heart Attack Symptoms

You get a heart attack when blood flow to your heart muscle gets restricted or blocked, often by a clot in an artery. Without oxygen, your heart muscle gets damaged or could even die.

A 2008 study in the American Journal of Critical Care found that chest pain is the most frequently reported heart attack symptom, and 61% of 256 participants said their symptoms were constant.

Your chest pain may feel like:

  • Discomfort
  • Pressure
  • Tightness
  • Burning
  • Fullness
  • Squeezing

"If you've not experienced it before, patients often aren't sure what it is when it first comes on," says Kristin Newby, MD, a cardiologist at the Duke Heart Center in Durham, NC.

The same study found that women were about 8 years older than men when they began to have heart trouble and were more likely to report a higher intensity of five other symptoms:

The study found that 21% of the women and 10% of the men had no symptoms at all. Less typical symptoms for both men and women are:

  • Discomfort in the neck, arms, jaw, back, or stomach
  • Shortness of breath
  • Dizziness
  • Cold sweat

"Men and women may respond differently to the symptoms of a heart attack, particularly if the symptoms are vague. But if you have symptoms consistent with a heart attack, don't wait at home. Go to the hospital," says Alfred Sacchetti, MD, an emergency room physician and an American College of Emergency Physicians spokesman.

Recognizing Angina

It's your body's warning sign that something isn't right with your heart. Angina is temporary chest pain or pressure that happens when arteries that supply blood and oxygen to your heart become narrowed or blocked. That means your ticker is getting less blood than your body needs to work right. Strong emotions, physical activity, hot and cold temperature extremes, or a heavy meal can often trigger it.

You may notice symptoms like:

  • Chest pressure or pain
  • Squeezing in your chest
  • Sense of fullness in the center of your chest
  • Pain or discomfort in your shoulder, arm, back, neck, or jaw

Types of Angina

Stable angina. Your narrowed arteries cause pain, pressure, and other symptoms when you move around. This may occur at regular times, and the symptoms usually go away after you rest. If you're under a doctor's care, you may take nitroglycerin to get relief.

"This is why people get pain or other symptoms when they do physical activities. They may feel fine walking around the house, but if they try to run to the mailbox before the mailman leaves, they would develop pain," says Holli A. DeVon, PhD, RN, an associate professor in the College of Nursing at the University of Illinois at Chicago.

Unstable angina. Sometimes the stable type turns into an unstable form. You may get chest pain that becomes more intense, lasts longer, or happens even when you're at rest.

"You might get chest discomfort walking up a hill, but it goes away when you sit and rest," explains Mohamud Daya, MD, associate professor of emergency services at Oregon Health and Science University in Portland. "What is really concerning is when the distance you can walk is getting shorter and shorter. That means there is less blood flow, and you are more likely to have a heart attack."

Take It Seriously

"Angina is a warning sign. It's basically giving you a heads-up there is a problem. It's telling you your heart muscle is not getting enough blood. There is a narrowing in your artery that can lead to a clot that could give you a heart attack," Sacchetti says.

Don't ignore it. Your doctor can recommend medications, balloon angioplasty, stents, or bypass surgery to open up your arteries and make sure your heart gets better blood flow.

Show Sources


CDC: “Heart Disease Facts,” "Heart Disease: Signs and Symptoms."

Mohamud Daya, MD, MS, associate professor of emergency services, Oregon Health and Science University, Portland, OR.

DeVon, H. American Journal of Critical Care, January 2008.

Holli A. DeVon, PhD, RN, associate professor, College of Nursing, University of Illinois, Chicago. 

Kristin Newby, MD, cardiologist, Duke Heart Center, Duke University Medical Center, Durham, NC.

Alfred Sacchetti, MD, emergency room doctor, Our Lady of Lourdes Medical Center, Camden, NJ; spokesman, American College of Emergency Physicians.

National Heart, Lung, and Blood Institute: "What Are the Signs and Symptoms of Angina?" "What Causes Angina?" "What Is Angina?"

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