Angina and Armpit Pain

What is angina?

Chest pain, underarm pain, symptoms, blood flow, unstable angina, muscle strain.

Chest pain is a fairly common symptom that variousa variety of things like cough, panic attacks, asthma, indigestion, and other related conditions can cause. So, for a lot of people, they may not mean anything. However, chest pain can also indicate a more severe condition like a heart disorder. 

Angina is chest pain that occurs when your heart is not getting as much blood as it needs.1 When this happens, the heart has to work overtime by beating harder and faster, to increase or improve the blood flow to it.2 It is usually a sign that your heart needs to rest. Angina itself is not a disease, but when it occurs frequently, it is often an indication that your heart is suffering from another condition like coronary heart disease (CHD) or coronary artery disease (CAD).3 Angina is an increasingly popular condition among people who are 45 years and older, although it is more common in males than females.  

If you notice recurrent chest pain that does not go away, you need to check with your doctor because angina can sometimes feel like regular heartburn, which some people experience when they have indigestion. 

Signs and symptoms (Brief)

It has been established that angina is usually a symptom of something else, but you can’t tell them apart unless your doctor has run some tests and confirmed it is angina. 

Angina can sometimes feel like a tightness around your chest, a dull ache, pressure on the chest, and even a burning sensation in the chest (which makes it similar in some ways to heartburn).

Some other symptoms of angina include:1,5

  • Dizziness 
  • Tiredness 
  • Shortness of breath 
  • Sweating 

According to the British Heart Foundation, people who have angina may not know where exactly the pain is from because rather than only chest pains, they may also feel some discomfort or pressure in the neck, jaw, shoulders, and arm. So, for many people, angina may be mistaken for a regular muscle strain, which usually eases off on its own.4,6  

Causes and risk factors (Brief)

It is not known, what the exact cause of angina is. Still, research shows that angina occurs when there is a mismatch between the amount of oxygenated blood that the heart needs at any given time and the amount of blood it receives. When this mismatch occurs, the heart works really hard to make up the difference, and it results in the pain that people feel, which is referred to as angina. In the majority of the patients that have ever shown up at the hospital with angina, it was observed that one or more of their coronary arteries was smaller than expected, which is indicative of a coronary heart disease.7 However, experiencing angina does not automatically mean having heart disease. It may sometimes indicate stress or anxiety, but you should check with your doctor, to be certain. 

Some risk factors for angina include: 

  • Being older: some studies put this number at 45 years and older, and some others at 60 years and older. However, the likelihood that you may experience angina increases as you age
  • Having one or more family members with a heart condition
  • High blood pressure
  • Diabetes
  • High cholesterol
  • Not enough exercise or physical activity 
  • Tobacco and other substance use

Diagnosis (Brief)

To diagnose angina, the doctor will ask questions about your symptoms, risk factors, family history, and medical history. These will provide information about the type of chest pain you are having and help the doctor to correctly determine whether it is angina or not. 

Also, to be certain, the doctor may recommend some additional diagnostic procedures like an Electrocardiogram (ECG)Chest x-ray, and Blood Tests

Management and treatment (Brief)

Treatment can effectively reduce the occurrence of angina attacks or stop them completely, to reduce the chances of complications or death. The recommended treatment may range from medicines to surgery, depending on how severe the angina attacks are. 

Some of the recommended treatments are 

  • Lifestyle changes: this involves becoming more physically active, reducing the use of tobacco and alcohol, and having a better diet. If you already have a chronic condition such as hypertension, diabetes, or high cholesterol, these changes will help to improve your outcomes and keep you in good shape
  • Medications: several medicines used to manage or treat angina are recommended if lifestyle changes do not improve the condition. Nitrates, Aspirin, Statins, Beta Blockers, and Clot-Preventing drugs may be recommended5,8
  •  The right medications and combinations will be determined by your doctor, based on the results of the tests, which will show what course of action will be the best fit for you
  • Surgery is usually a last resort if the other two do not work out

Prevention (Brief)

Since it has been established that angina attacks are most often linked with a heart problem, the best course of action for prevention would be to take care of your heart. Taking care of your 

heart involves doing everything to ensure that your heart is in good shape, this includes:

  • exercising regularly
  • if you smoke currently, quit 
  • eat healthy 
  • listen to your body

Angina and armpit pain

Pain in the armpits can be caused by a range of factors or conditions, ranging from the simple and common muscle strains to more severe cases like breast cancer. The armpits are very close to the chest, so it is not surprising that any condition that affects the chest will also affect the armpits. 

The armpits are a pair, so when you experience pain in one of them, affects the other simultaneously. However, when chest pains occur together with left armpit pain, it usually indicates that a person is having an angina attack and may be suggestive of something more severe. It can often be detected by monitoring the flow of pain - if the pain feels like it is spreading from your chest to your armpit, it may be a sign of angina. This combination of chest and armpit pain may not last long and would usually resolve once the root cause is addressed, with the use of medication.9 

Other causes of armpit pain

Your armpits go through a lot each day, and any of these can cause pains or adverse reactions. We will explore some of these other causes of armpit pain below:

Allergic reaction 

Your body may be reacting to something which presents itself by causing pain in the armpit. In addition, ingrown hairs can cause skin irritation. Also, irritants such as deodorant or detergent can cause contact dermatitis. This is an allergic reaction that results in an itchy or painful rash.

Changing out of wet or sweaty clothes can help prevent these problems. This can easily be treated by using a warm compress or discontinuing the products on your armpit until the problem goes away.9

Infection

Bacterial skin infections, such as folliculitis or cellulitis, can also occur in the armpit because it has a lot of folds and creases8,9. Folliculitis is the infection of a hair follicle infection under the arm. Cellulitis causes deep skin damage and can spread to other parts of the body through the bloodstream. When these infections become severe, they may cause severe armpit pain, fever, and chills. Antibiotics may be required to treat these infections.9 

Muscle strain

According to Dr. Schwartz, “The armpit is a common location for muscle strains. Strains usually occur when trying to lift a heavy object, working out too vigorously, or performing repetitive motions. The pain of muscle strains may come on quickly, if there is a sudden injury, or may develop over the course of a day or so”.9

Lifting a heavy object, working out too hard, or performing repetitive motions like snow shoveling can all cause a strain in the muscles around the armpit or rib cage.

Rest, heat and ice can all help to alleviate symptoms.2,7 Consult a doctor if symptoms persist for more than three weeks or interfere with daily activities such as washing your hair, putting on clothes, or reaching overhead.

Breast cancer

Most armpit pain is caused by something that can be easily resolved, but it could be a sign of breast cancer that has spread to other parts of the chest. Breast cancer can be painless for a time, but it can also cause chest pain in some cases. While breast cancer usually affects women, men can also get it, though it is rarer.

Warning signs of breast cancer include a lump in the breast, a change in the appearance of a breast or nipple, and nipple discharge. Only about 10% of cases are thought to be genetic in nature. Other risk factors include being older, smoking, drinking alcohol, being overweight or physically inactive, using hormones, having dense breasts, having a history of radiation to the chest, and not having children.10

As with any cancer, early detection improves recovery chances. Going in for screening as recommended by your doctor is the most effective way to detect breast cancer early — a mammogram can detect cancer in the breast much earlier than a self-exam can, up to 2 years earlier. The American Cancer Society recommends annual mammograms for women over the age of 40.

Swollen lymph nodes

Lymph nodes are in charge of draining fluid and waste from other parts of the body. They play an important role in infection resistance and can swell when they trap viruses or bacteria. They, too, may become infected.

Swollen lymph nodes may be a sign of a viral or bacterial infection. They may also enlarge if you have a bug bite—or for no apparent reason.9

You may notice a lump or bump that will go away in a few days. If it does not, or if it continues to grow, becomes more painful, or you notice fluid, consult a doctor.

When to see a doctor

If your armpit pain does not seem to improve on its own, or if you notice swelling, a rash, or a lump in your armpit, consult a doctor.

Suppose the pain is caused by a temporary skin condition such as a boil, cyst, or ingrown hair. In that case, you should see a doctor if:

  • The pain does not reduce but gets more severe
  • After a week of self-treatment, it worsens or shows no signs of improvement
  • You get a fever
  • The armpit pain is a recurring issue
  • You have a weakened immune system

Summary

Chest pains may be caused by a series of conditions, but angina is a special type of chest pain that is often caused by a heart condition. 

Due to the location of the armpits, they can be easily affected by several conditions, including muscle strains, infections, allergic reactions, swollen lymph nodes, angina, and breast cancer. If you notice pain in your armpits that does not resolve on its own, you should see your doctor. 

References

  1. Angina (Chest pain) - what is angina? | nhlbi, nih [Internet]. [cited 2022 Oct 20]. Available from: https://www.nhlbi.nih.gov/health/angina 
  2. Just a dull ache or angina? [Internet]. Heart Foundation NZ. [cited 2022 Oct 20]. Available from: https://www.heartfoundation.org.nz/your-heart/heart-conditions/angina 
  3. Angina(Chest pain) [Internet]. www.heart.org. [cited 2022 Oct 20]. Available from: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain 
  4. Angina - Causes, symptoms & treatments [Internet]. [cited 2022 Oct 20]. Available from: https://www.bhf.org.uk/informationsupport/conditions/angina 
  5. Angina - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Oct 20]. Available from: https://www.mayoclinic.org/diseases-conditions/angina/symptoms-causes/syc-20369373 
  6. Hermiz C, Sedhai YR. Angina. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Oct 20]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK557672/ 
  7. Rousan TA, Thadani U. Stable angina medical therapy management guidelines: a critical review of guidelines from the european society of cardiology and national institute for health and care excellence. Eur Cardiol [Internet]. 2019 Apr [cited 2022 Oct 20];14(1):18–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6523058/ 
  8. Angina - treatment [Internet]. nhs.uk. 2017 [cited 2022 Oct 20]. Available from: https://www.nhs.uk/conditions/angina/treatment/
  9. 4 reasons you have armpit pain | buoy health [Internet]. 2018 [cited 2022 Oct 20]. Available from: https://www.buoyhealth.com/learn/armpit-pain 
  10. Acs breast cancer screening guidelines [Internet]. [cited 2022 Oct 20]. Available from: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html 
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Toluwanimi Ojeniyi

Master of Science - MS, Global Health, University of Ibadan, Nigeria

Toluwanimi is a Public Health specialist with experience in programs administration and health insurance. She is currently undertaking a Masters in Global Health at the University of Ibadan.
She is a skilled health educator and health writer. In her free time, she reads and volunteers.

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