What is the Difference Between Angina and Heart Attack?

Angina can be thought of as a symptom of a potential future heart attack. While both include chest pains, angina chest pain is the result of an inadequate supply of blood to the heart due to some blockage in the blood vessels. In contrast to this, a heart attack happens when the blood flow is so inadequate that the heart muscles start getting damaged to the point where the damage may not be reversible. This may also lead to heart failure depending upon the severity of the blockage. 

Symptoms of Angina

Some types of pain, such as in the back, neck, jaw, or arms could be a symptom of Angina. Angina can be relatively common but sometimes it may be difficult to distinguish it from other types of digestive issues. This makes it very important for a person to be on the lookout for chronic chest pains. 

Chest pain caused by angina may resemble a squeezing or burning pain in the region. Other symptoms may also include:

• Excessive sweating
• Breathing problems
• Nausea 
• Dizziness

Angina could either be stable or unstable. Chest pain caused by overexertion in the gym is an example of stable Angina. This usually goes away after taking appropriate rest. Unstable angina on the other hand is much more severe and may potentially lead to heart attacks in the future.

Angina is characterised by a burning or squeezing pain in the chest region near the heart. Diagnosis depends on the severity and duration of the chest pain. Stable angina wears off with time and rest. This is usually a result of the heart doing extra work due to increased physical or mental labour. Whereas unstable angina persists for some time and may even occur when the body is at complete rest. Unstable angina is considered to be severe and immediate medical help should be sought at this point. 

Is Angina Life-Threatening?

No, angina is just a symptom of a probable coronary artery disease, which could subsequently cause a heart attack or stroke. Although not lethal, unexpected and severe angina pains which last for 30 minutes or more should be looked out for, and a doctor’s advice should be consulted.

Symptoms of Heart Attack

The major symptoms of a heart attack include:

• Recurring or lasting chest pain. This usually happens towards the left side of the chest or near the centre.
• Hampered breathing: Discomfort near the chest area may lead to breathlessness.
• The person may feel very weak, which may lead to fainting.
• Cold sweating.
• Pain in arms, jaw, back, neck, or shoulders.

According to the CDC, feeling nauseous, lightheaded, or unusually tired is more pronounced in the case of women than men.¹

Causes

A heart attack can be the result of sustained unstable angina due to the process of atherosclerosis. This condition results in a barrier (plaque) forming inside the arteries, which restricts blood flow through the heart. This barrier or block is slowly developed as a build-up of different materials with fatty residues acting as a glue to hold it in place in the blood vessel. The plaque may contain different proteins such as fibrin, dead cells, or small clots.

This plaque can restrict blood flow through the heart and lead to permanent damage to heart muscles caused by a lack of oxygen. If it gets dislodged from its original artery the plaque might travel with the blood and reach finer capillaries in important tissue like the brain. This can lead to a stroke or brain haemorrhage.

Can unstable Angina lead to heart attack?

Yes, unstable angina can be seen as a warning sign for a potential future heart attack and this should be immediately addressed by visiting the doctor for a consultation.

Causes of Unstable Angina

Unstable angina may be caused due to a spontaneous rupture in the plaque in the artery. This may rapidly change the blood flow in the artery, even completely blocking it. At this point, unstable Angina becomes a full-blown heart attack and this may lead to irreparable damage to the heart muscles. Depending on the severity, it could even lead to death if surgery isn’t performed in due time.

Prinzmetal’s Angina

Stable angina may be caused by a sudden rapid increase in the heart’s work and unstable angina due to plaque formation in arteries. Another type of angina, known as Prinzmetal’s angina, involves a sudden spasm in the coronary artery.² This spasm leads to a temporary blockage of blood flow, causing the heart to release stress signals in the form of pain.

Causes of Prinzmetal’s Angina

Prinzmetal’s angina may be caused by factors like various mental and emotional stresses. However, some other external factors include smoking, certain medications, and narcotic substances like cocaine, also trigger Prinzmetal’s angina. 

Ways to Reduce the Risk of Angina and Heart Attack

Understanding the risk factors of coronary artery disease can help adjust your lifestyle accordingly. This can help you to be conscious of your heart’s health and lead you to undertake a healthier lifestyle. 

Risk factors for coronary artery disease

The major risk factors affecting heart health are listed as follows:

• Tobacco use: any type of tobacco use may increase the cholesterol deposits in the arteries, leading to artery hardening and plaque formation. This formation may become severe and may lead to ischemic heart disease (the main cause of angina at this point). This could ultimately lead to myocardial infarction (heart attack). 
• Diabetes: diabetes speeds up atherosclerosis (plaque formation in the arteries) and also increases the cholesterol levels in the body. 
• High blood pressure: the plaque in the arteries increases the blood pressure in the blood vessels. This can cause damage to sensitive capillaries in major organs, including the brain. This condition may lead to multiple organ failures. High blood pressure also accelerates coronary artery disease through increased hardening of arteries.
• Family history: if a family member has a history of coronary artery disease, then blood relatives have a higher chance of developing the same. 
• Older age: arteries harden with age and several blocks start forming slowly in the arteries, hence people of old age may be more susceptible to ischemic heart disease and myocardial infarction.
• Lack of exercise, excessive stress, and obesity: a lack of exercise, and obesity, can directly influence the clogging and hardening of arteries. Stress may disturb the heart and accelerate the associated casualties of coronary artery disease. High stress, short temperedness, and unexpected surges in hormones may also be a threat to the heart’s health.

Making changes in one’s lifestyle and considering the above risk factors can help avoid angina and heart attacks. If one is already suffering from angina, the following can be done to reduce the problems:

• Maintaining the appropriate BMI (body mass index)
• Quitting or reducing alcohol consumption
• Getting the flu vaccine to combat potential heart problems caused by flu viruses

There are several medications used to treat Angina.^3. The doctor may prescribe a particular medication according to the condition of the patient’s body. Self-medication should never be done and professional help should be sought to reduce complications. Some of the medications include:

• Aspirin: reduces the clotting ability of the blood and eases its flow through the blood vessel. Other antiplatelet medications may also help
• Nitrates: help by inducing relaxation in the blood vessels. This can help in increasing the blood flow to the heart
• Beta-blockers: reduce the stimulatory effect of hormones like adrenaline and noradrenaline. In turn, reducing the heart’s beating and reducing the angina pain

All prolonged chest pain should be taken seriously and a routine heart health checkup should be undertaken to keep you and your heart healthy.

Summary

The main symptom of angina is chest pain and, while not necessarily a cause for concern, it may signal wider heart problems. If symptoms persist or worsen in severity, consult your doctor as soon as possible. To prevent angina from worsening, practise healthy habits, such as exercising, eating a balanced diet, and stopping smoking.