Angina is chest discomfort that occurs when your heart isn’t receiving enough blood, usually due to a blockage in a coronary artery. A heart attack occurs when blood flow is severely reduced or cut off, causing heart tissue damage or death.

The term “angina” refers to chest discomfort caused by myocardial ischemia, which is reduced blood flow to the heart muscle.

A heart attack occurs when there is damage or death of the heart tissue due to insufficient blood flow to the heart. This is usually due to severe or complete obstruction of a coronary artery. Symptoms can include angina, chest pain, shortness of breast, nausea, and lightheadedness.

Understanding the similarities and differences between angina and a heart attack can help you respond safely and correctly when symptoms develop in you or someone you know. Read on to learn more.

Angina is a type of chest discomfort that occurs when blood flow to the heart is reduced, depriving that muscle of the oxygen and nutrients it needs to work optimally. It can feel like tightness, squeezing, or pressure in the chest.

Angina can be either stable angina (sometimes referred to as “chronic angina”) or unstable angina.

  • Stable (chronic) angina: This type occurs predictably after a certain level of activity. Someone who has been diagnosed with stable angina may experience symptoms after walking for two blocks, for example.
  • Unstable angina: This is new angina or a change in angina symptoms, such as an increase in episode frequency or an episode brought on by less exertion. For example, a person who may normally experience angina after walking for two blocks may now experience it after walking for half a block or even at rest.

A person with stable angina may have a few episodes per year or a few episodes per month. A 2021 survey study found that about 1 in 5 participants with coronary artery disease (CAD) experienced angina attacks at least once per month, while about half of those people have at least one episode per week.

Treat an episode of unstable angina as a medical emergency

The American Heart Association recommends that an episode of unstable angina be treated as a medical emergency, as it might instead be a heart attack.

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A heart attack occurs when a blocked coronary artery is completely blocked, cutting off blood circulation to the heart. Symptoms of a heart attack include:

  • pain or discomfort in your chest
  • shoulder, neck, or jaw pain
  • sweating
  • nausea
  • lightheadedness
  • shortness of breath

Angina vs. heart attack symptom comparison

Determining whether your chest pain is the result of angina or a heart attack isn’t always easy. But here are a few helpful distinctions.

AnginaHeart attack
Episodes usually last a few minutes, typically no more than 5 minutesPain usually lasts for more than half an hour or may come and go several times
Pain typically subsides with rest and/or medication (in the case of stable angina)Pain is constant or worsening

Stable angina is usually a sign that you have a narrowed coronary artery — a condition that can also trigger a heart attack. Stable angina is not necessarily a warning that a heart attack is imminent. It is, however, a condition that increases your risk for heart attack.

A 2016 study suggested that, among people with established CAD, individuals who also had angina were at higher risk for coronary revascularization, stroke, and heart failure compared with CAD patients who did not experience angina.

A 2020 study suggests that about half of the people with angina did not have obstructive CAD, however. Obstructive CAD is defined as having a significant blockage in the epicardial coronary arteries, the larger arteries supplying blood to the heart.

Many of these study participants had problems with the heart’s smallest blood vessels. This is called microvascular angina, and it can often be treated with medications and lifestyle adjustments.

If you’ve been diagnosed with stable angina, your doctor may have prescribed medications, such as nitroglycerin, to help ease angina symptoms.

Nitroglycerin is available as a tablet you dissolve under your tongue, a spray aerosol solution, a transdermal patch, and ointment. Your doctor will tell you how much nitroglycerin to take, what form you should use, and how to take it.

In addition to nitroglycerin, your doctor may have also prescribed medications to manage underlying conditions that contribute to stable angina. These conditions include high blood pressure, high cholesterol, diabetes, or a combination of these.

Call 911 if rest and your usual medications aren’t easing your angina

Chest pain that seems different from your typical episodes of chronic angina should be considered a possible heart attack. If the pain lasts longer than usual or feels more intense than usual, assume it might be a heart attack.

Other symptoms that may suggest you’re having a heart attack and not an episode of angina include:

  • cold sweat
  • dizziness, lightheadedness, or weakness
  • feeling of impending doom
  • nausea and vomiting
  • pain in the jaw, neck, shoulders, arms
  • shortness of breath

Keep in mind that chest pain may be your only symptom, or you may experience some symptoms intensely, while chest discomfort seems mild. And if you’ve had a heart attack previously, remember that a second heart attack may feel much different than the first one. Each heart attack is unique.

Call 911 or ask someone to call 911 if you think you may be experiencing a heart attack.

Calling 911 is typically the fastest way to get emergency care, as opposed to asking someone to drive you to a hospital in their car. EMS workers are trained to treat the dangerous arrhythmias or cardiac arrest that people may experience during a heart attack and can transport you to the hospital for rapid care.

Angina is chest discomfort due to myocardial ischemia (reduced blood flow to the heart muscle).

A heart attack is an event triggered by a severe blockage in a coronary artery (which blocks off blood flow to the heart).

There are two types of angina: chronic stable angina and unstable angina. Stable angina is when you experience predictable bouts of chest discomfort from physical exertion. Unstable angina is new, more frequent, or worsening bouts of chest discomfort.

Unstable angina should be treated as a medical emergency, as it might instead be a heart attack.

While previous angina episodes might have come and gone without any serious complications, always take any chest discomfort, tightness, or pressure seriously and be ready to call 911 if you suspect that a bout of angina might possible be a heart attack.