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Conditions InDepth: Coronary Artery Disease (CAD) and Angina
Coronary Artery Disease (CAD)
|Blocked Coronary Artery|
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- Duration of pain —In general, anginal pain lasts for only a few minutes and is relieved by rest or nitroglycerin. Heart attack pain is usually more severe than anginal pain and may last longer, often 15 minutes or more. Pain that lasts less than 30 seconds and goes away with a few deep breaths or a change in position is usually not angina.
- External factors—Anginal pain is often brought on by exercise or activity, emotional tension, dreams, cold or windy weather, low blood sugar, or even eating. Your symptoms can subside when you alter the behavior or environmental trigger. Heart attack pain will usually not subside with rest and may be accompanied by other symptoms such as shortness of breath, nausea, or sweating. The elderly or people with diabetes may have less typical or more subtle symptoms signaling angina or heart attack. Some people may have “silent ischemia” and experience no symptoms.
- Stable angina—The attacks are predictable, and the triggers that cause them can be identified. They do not occur when you are resting or relaxed, and symptoms will usually disappear after a few minutes of rest.
- Unstable angina—The symptoms are less predictable. Chest pain may occur while resting or even sleeping (nocturnal angina), and the discomfort may last longer and be more intense. Stable angina becomes unstable when symptoms occur more frequently, last longer, or are precipitated more easily. You should call your doctor immediately if you experience symptoms at rest, or a worsening pattern of symptoms.
- Variant or Prinzmetal's angina—This is usually caused by the spasm of a coronary vessel. It occurs when you are at rest and often in the middle of the night. It can be quite severe and in some cases associated with arrhythmias or abnormal heart rhythms.
American Heart Association. Cardiovascular disease statistics. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4478 . Accessed June 18, 2009.
Braunwald E, Zipes D, Libby P. Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, PA: WB Saunders; 2001
DynaMed Editorial Team. Angina. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 9, 2010. Accessed November 11, 2010.
National Heart, Lung, and Blood Institute. Coronary artery disease. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD%5FWhatIs.html . Updated February 2009. Accessed June 18, 2009.
- Reviewer: Michael J. Fucci, DO
- Review Date: 09/2013
- Update Date: 09/30/2013