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Angina - Stable/Unstable

What is angina?

Stable angina

Unstable angina


What is Angina?

Angina pectoris ("angina") is a discomfort (or pain), usually felt in the chest, that comes from the heart muscle.  You usually feel it as a tightness, heaviness, weight, pressure or some similar feeling.  It may also spread to the throat, jaw, shoulders or back.  Sometimes you might also notice aching or tingling in your arms or hands when you have angina.  You may also experience breathlessness.

Sometimes doctors and nurses use a "shorthand" name - CHD (coronary heart disease) or IHD (ischeamic Heart Disease) for clogged up arteries.  Don't let this confuse you it is not a different illness, just a different name. 

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Stable Angina

You will usually get your angina by doing something energetic or by getting excited or upset.  You might find it worse in cold weather.  We call this kind of angina "stable" angina. 

Angina is caused by the heart muscle not getting enough blood; it occurs when there is an insufficient supply of blood due to the narrowing of the coronary arteries (blood vessels) that bring blood to the heart muscle.  Normally there is a sufficient flow of blood to the heart muscle at rest or during light activity.  With more energetic activity (or when you get excited or angry) the heart has to pump harder and faster and the muscle need more blood (just like a car uses more petrol when it goes faster or climbs a hill).  If the coronary arteries are narrowed the blood flow passing through them cannot increase and the heart muscle complains about the blood supply not matching what it needs.  You feel this as angina.  In many ways angina is like a muscle cramp in the arm or leg; which occurs when the working muscle does not get enough blood to match what it needs.  Angina warns you to stop and rest for a few minutes or calm down a bit.
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Unstable Angina

If your angina suddenly comes on more often and/or the attacks are more uncomfortable or last longer, we call it "unstable" angina.  It is much less common than "stable" angina.  The attacks may come on with less exercise than usual or even at rest.  Sometimes this is how a patient first experiences angina but very often unstable angina happens in a patient who has previously had ordinary (or "stable") angina for months or years. 

Unstable angina occurs when an artery becomes very narrow indeed, so that even the blood supply to the heart muscle when you are at rest may not be enough.  Unstable angina is an emergency and requires urgent admission to hospital. 

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