Angina vs. heart attack: Is my heart trying to tell me something?

Have you ever felt a sudden tightness in your chest and wondered, "Is this just heartburn or something more serious?" When should you pay attention to the fact that your heart might be trying to tell you something?

Let's face it: chest pain can be scary. And while not all chest pain means you're having a heart attack, it's never something to brush off.

Two common heart conditions that cause chest pain are angina and heart attacks. Though they share similarities, they're quite different in terms of what's happening inside your body and how urgently you need medical attention.

Understanding the difference between angina vs. heart attack could literally save your life—or the life of someone you love. Here’s what you need to know about each.

What is angina?

Angina is essentially your heart crying out, "Hey, I'm not getting enough oxygen!" It happens when the blood flow to your heart muscle is temporarily reduced, usually due to narrowed coronary arteries. The result? A painful pressure or squeezing sensation in your chest that can feel frighteningly like a heart attack.

There are two types of angina:

• Stable angina: This is the most common type and follows a predictable pattern. It typically occurs during physical exertion or emotional stress and goes away with rest or medication within a few minutes. It’s your body’s way of telling you to slow down. People typically have a history of this happening to them in the past, so it is always a repeat of what they have previously experienced.
• Unstable angina: This is the troublemaker. It can occur even at rest, lasts longer, and may not be relieved by rest or medication. Unstable angina is unpredictable and can be a warning sign that a heart attack might be imminent. Any chest pain occurring for the first time or with no history could potentially be considered unstable angina. If it lasts longer than a few minutes and is not attended to by medical professionals in a timely manner, it may convert into a heart attack.

What happens during a heart attack?

A heart attack, otherwise known as myocardial infarction, is much more serious than angina. While angina is caused by reduced blood flow, a heart attack occurs when the blood flow to part of your heart is completely blocked, or the reduction in the blood flow lasts long enough to damage the heart cells.

Without blood, the heart muscle begins to die. Unlike angina, which is temporary and doesn't damage your heart, a heart attack causes permanent damage. That's why immediate medical attention is crucial—every minute counts when it comes to saving heart muscle. This becomes more important when we are dealing with unstable angina, which has the potential to convert into a heart attack, damaging the heart or part of the heart muscle permanently.

Angina vs. heart attack: Spotting the critical differences

How can you tell the difference between angina vs. heart attack when you're experiencing symptoms? Here's a quick comparison:

Remember: if you're not sure whether you're experiencing angina or a heart attack, always seek emergency medical attention.

Is angina a heart attack?

This is one of the most common questions people ask, and the answer is no—angina itself is not a heart attack. Think of angina as a warning sign that your heart isn't getting enough oxygen temporarily, while a heart attack means that part of your heart is being damaged due to a lack of blood flow.

However, since unstable angina can be a precursor to a heart attack, it should be taken very seriously. It indicates that either:

• Blood supply shortage to the heart muscle has been low for too long, causing the muscle to go from being injured to dead.
• A plaque deposit in your coronary artery may be about to rupture and cause a complete blockage, leading to permanent damage.

Can angina cause a heart attack?

It’s possible for angina to cause a heart attack. But fortunately, there are things you can do to take care of your heart and lower your risk of a heart attack.

The first thing you can do is understand the pattern of your symptoms. A change in the pattern of your angina symptoms (becoming more frequent, occurring with less exertion or happening at rest) should always prompt immediate medical attention, as this, by definition, is ‘unstable’ and could indicate unstable angina, leading to a heart attack.

If you know you have angina, the following steps can help prevent a heart attack:

• Taking all medications exactly as prescribed
• Attending follow-up appointments with your cardiologist
• Making recommended lifestyle changes (diet, suggested exercise, smoking cessation, etc.)
• Learning to recognize changes in your angina pattern that might signal a problem
• Putting in place your emergency plan if symptoms worsen

The good news is that proper management of angina and its underlying causes can significantly reduce your risk of experiencing a heart attack. Talk to your doctor if you have any questions about how you can better manage your angina and care for your heart health.

Prevention: Taking heart health into your own hands

Many of the risk factors for both angina and heart attacks can be managed with lifestyle changes and medical treatment. Here's what you can do:

• Get moving: Regular physical activity strengthens your heart and improves circulation. Any activity is better than no activity. Ideally 30 minutes of brisk walk daily for 5 days of the week is recommended.
• Eat heart-healthy: A heart-healthy diet rich in fruits, vegetables, whole grains and lean proteins helps prevent plaque buildup.
• Stop smoking: Smoking (nicotine of any kind, even vaping) damages blood vessels and accelerates plaque buildup.
• Manage stress: Chronic stress raises your blood pressure and can trigger angina episodes.
• Control other conditions: Manage diabetes, high blood pressure and high cholesterol through medication and lifestyle changes.
• Know your numbers: Regular check-ups help monitor your blood pressure, cholesterol and blood sugar levels.
• Take medications as prescribed: If your doctor has prescribed medications for angina or to prevent heart attacks, take them exactly as directed.
• Pay attention to new symptoms: If you experience any new or changing symptoms, please inform your doctor immediately so appropriate steps can be taken to address them.

The bottom line on angina vs. heart attack

Don't play detective during a potential heart emergency. Call 911 immediately if you experience the symptoms of unstable angina or a heart attack.

And if you've experienced new chest pain or discomfort or even shortness of breath, don't self-diagnose. Talk to your primary care physician, who can refer you to a heart specialist if needed. Your heart works tirelessly for you every day—isn't it time to return the favor?

For more information about angina, heart attacks, and comprehensive Heart and Vascular Care, speak with your primary care physician about a referral to a cardiac specialist.