Stable Angina

What is stable angina?

Stable angina is a type of chest pain or discomfort that’s short in duration (around five minutes) and consistent in how it feels each time it occurs. It happens when your heart muscle needs more oxygen than usual but isn’t getting it at that moment because of heart disease. Episodes come and go in predictable patterns. For example, they may occur when you’re moving around.

Stable angina is a symptom of coronary artery disease (CAD). This means there’s a sticky substance called plaque in the arteries that supply oxygen-rich blood to your heart. This plaque narrows your arteries and makes it harder for blood (and oxygen) to flow through.

Rest and medicine can stop an episode of stable angina. But this symptom is still serious and potentially dangerous. That’s because it can get worse or become unstable over time. In other words, it can progress to a complete blockage, causing permanent heart damage (a heart attack). For example, episodes might last longer or occur at times you can’t predict — even while you’re resting. Or you may need more doses of medicine to make the pain go away.

Stable angina is your heart’s way of telling you it needs your attention. Without treatment for CAD, you’re at risk of a heart attack. Your healthcare provider may recommend medicines, procedures and changes to your daily habits to help protect your heart.

What does stable angina feel like?

Stable angina causes chest pain or discomfort that may feel like pressure, heaviness, squeezing, burning or indigestion. The discomfort may spread from your chest to your left shoulder, left arm or other nearby areas.

You may also have symptoms like:

• Shortness of breath
• Dizziness
• Nausea
• Fatigue

What’s the most common cause of stable angina?

Coronary artery disease causes most cases of stable angina. Other causes include:

• Heart failure
• Problems with your heart valves
• Problems with your heart rhythm
• Hyperthyroidism
• Anemia

Common triggers for a stable angina episode include physical exertion, stress, strong emotions and sudden changes in the temperature around you (like going into a very hot or cold room).

How is stable angina treated?

When you first notice an episode of stable angina starting, you should:

• Stop what you’re doing
• Sit down and rest
• Take nitroglycerin if your provider prescribes it for you

Resting and taking your medicine should make stable angina go away within five minutes. If not, you may need to take another dose of medicine. Your provider will tell you how many doses you should take before seeking medical care. Follow their guidance closely.

To help prevent stable angina from happening again, your provider may prescribe other medicines for you to take. These may include beta-blockers, extended-release nitroglycerin or ranolazine.

You may also need treatment for the condition that’s causing your angina. For example, if you have coronary artery disease, you may need stents or bypass surgery. Your provider will explain your treatment options, along with the benefits and risks.

Can this symptom be prevented?

The best way to prevent stable angina is to lower your risk of coronary artery disease. If possible, start working with a preventive cardiologist early in life. This is especially important if heart disease runs in your biological family. Your provider will help you find ways to lower your risk. These include:

• Eating heart-healthy meals
• Getting enough physical activity each day
• Taking medicine to manage conditions like high blood pressure, high cholesterol and diabetes
• Not smoking or vaping
• Finding healthy ways to relieve stress

When should I see a healthcare provider?

Stable angina isn’t something you can manage alone. If you’re having chest discomfort for the first time, seek medical care right away. Your provider will do a physical exam. They may also do tests, including:

• Blood tests
• EKG
• Stress test
• Coronary angiography
• CT scan

These tests help your provider diagnose the problem and plan your treatment.

If you’ve been diagnosed with stable angina, your provider will tell you how to treat it at home and when to seek care.

When to go to the ER

You should call 911 or your local emergency services number if:

• The nitroglycerin you took doesn’t help (your provider will tell you how many doses to take before seeking care)
• The pain you had comes back or gets worse
• The chest pain you’re having feels different from usual

Is stable angina dangerous?

Stable angina can be dangerous, but it’s mostly a warning sign that you could be at risk of a heart attack. You probably need to make some lifestyle changes.

Can stable angina lead to a heart attack?

Yes, if you have stable angina, you could have a heart attack in the future if you don’t reduce your risk.