Do you feel like someone is squeezing your heart when you get stressed? Perhaps you feel pain in your left arm? Or experience indigestion when you exercise?
You could be experiencing angina, or the symptoms people feel when part of the heart muscle is not getting enough oxygen-rich blood flow.
Angina, which becomes more common as people age, can be a sign of other significant health issues, like coronary artery disease. The majority of people who experience angina do so because of plaque build-up on the wall of one or more coronary arteries that slowly and steadily constricts blood flow to the heart. If that artery suddenly becomes completely blocked, a heart attack occurs.
If you’re experiencing angina, it’s important to understand the patterns—for example, what causes it, what relieves it (or makes it better) and how long it lasts—and know how to react appropriately. We caught up with Laxson to talk about five things we should know about angina.
There are two major types of angina: stable angina and unstable angina. Other variations of angina exist, but are rare.
If the angina continues for more than 20 minutes, the health risks increase significantly. “A heart attack is basically when angina doesn’t go away after 20 minutes,” Laxson said. “Once it goes on for 30 minutes or more, you start to see permanent heart damage happening.”
“People are used to thinking it’ll be pain in their chest that radiates down their left arm,” Laxson said. “Some people with angina experience that—but many people do not.”
Are you unsure whether you’re experiencing angina? If so, take note of repeating patterns. How long do the symptoms last? Do the symptoms start because of exercise, eating or stress? Do they stop if you stop exercising? Where does the pain occur? Does a change in your position trigger the symptoms? Does deep breathing or coughing affect the symptoms?
If you’re regularly experiencing symptoms that fit some of these patterns, then it may be time to meet with your primary care physician. If the pattern grows less predictable, you could be experiencing unstable angina. It’s always better to err on the side of caution, but Laxson shared this general rule: “As long as it goes away and stays away, you can predict when it’s going to come and it doesn’t last longer than 20 minutes—then you don’t have to go to the emergency room or call the paramedics,” he said.
If it is a partial obstruction, treatment may include medication, surgery or placement stent. A total obstruction may lead to a heart attack.
In some cases, the body may create small blood vessels to reroute blood flow around a blocked artery—but only if the blockage builds slowly, allowing the body time to adapt. This is known as chronic total occlusion (CTO).
These reroutes provide enough blood flow to the heart to prevent a heart attack, even though there is 100 percent blockage. Historically, the main treatment for a total occlusion has been medication or bypass surgery. Now, however, University of Minnesota Health cardiologists very often use a less-invasive catheter method to navigate through the blockage and place a stent in the blood vessel that can relieve even a chronic total blockage.
“Many patients with CTO may have been told by doctors that medical therapy is the only option, but often we are now able to correct an occlusion with a successful stent procedure,” Laxson said.