Stable Vs. Unstable Angina

08/13/08 Disease Basics

Nearly 7 million Americans have angina. Some of those 7 million report their angina discomfort is hard to describe. Others say they can’t explain exactly where their pain comes from.

Angina symptoms may include nausea, feeling very tired, shortness of breath, sweating, and feeling light-headed or weak. Women often feel discomfort in the back, shoulders, and abdomen.

According to a recent study that analyzed thousands of cases of angina among both sexes in 31 countries, women had a 20 percent higher rate of stable angina than men. However, men had a higher rate of heart attack. More research needs to be done to understand why this difference occurs.

Stable angina, the most common type of angina, occurs when the heart is working harder than usual. It has a regular pattern that patients can learn to recognize, predict, and manage. The episode usually lasts five minutes or so and is relieved by rest or medication. A bout of stable angina may feel like gas or indigestion, or it may feel like chest pain that spreads to the arms, back, or other areas.

Unstable angina has no particular pattern. It can happen when you are resting, sleeping, and without exerting yourself. It usually comes as a surprise, bringing severe pain that may last as long as 30 minutes. Rest and medication may not help unstable angina, and the condition may continually worsen. Any chest pain that lasts longer than a few minutes and is not relieved by rest or angina medicine may mean you are having or are about to have a heart attack. Call 911 immediately.

If you have either stable or unstable angina you are at higher risk for a heart attack than someone without the condition. Talk to your doctor about an emergency action plan. As part of the plan you and your family members should know:

• The signs and symptoms of a heart attack.
• How to use aspirin or nitroglycerin if these have been prescribed.
• How to get emergency medical services where you live.
• The location of the nearest hospital that provides 24-hour emergency care.

There is a chronic angina clinical trial accepting participants. This trial will evaluate the effectiveness of an investigational treatment for chronic angina in women. Click here for more information.

Mari S. Gold is has written for The New York Times, American Profile, Relish Magazine, TravelSmart, Indianapolis Monthly, and numerous e-zines. An avid cook and foodie, she contributes restaurant reviews to Zagat Guides and The Vermont News Guide, and is working on a young adult novel with a food theme. Married with grown children and two cats, she divides her time between New York City where she is director of communications for a major health care organization, and Dorset, Vermont.