Angina (pronounced an-ji-na) or angina pectoris is produced when the supply of oxygen that is carried by blood is unable to meet the demands of the heart muscle. The decreased supply of blood is created by an obstruction within the coronary artery which impedes blood flow across it. Atherosclerosis is the commonest cause of obstruction. However, obstruction may also result from coronary artery spasm or the use of "crack" cocaine. Angina pectoris is a recurring symptom and usually occurs in the form of chest discomfort (tightness, fullness, squeezing, heaviness, burning or pain) in the center of the chest and /or over the left breast). The discomfort may move to the left shoulder and arm (although it may move to both shoulders/arms, throat, jaw, or even the lower portion of the chest or upper abdomen). It may be accompanied by shortness of breath, sweating, weakness, dizziness or nausea, or numbness in the shoulders, arms and hands. When the build up of plaque is gradual, the patient's symptoms are relatively predictable and stable. Such patient's usually have symptoms that are provoked by specific levels of exercise. They are generally brief, last only 2-3 minutes, and subside promptly with cessation of exercise or following the use of a nitroglycerin tablet. This pattern of pain is known as stable angina. The partial and temporary decrease in oxygen supply to the heart muscle does not generally cause permanent damage (unlike a heart attack).

   Some patients may have atypical (not typical) symptoms. For example, the pain may be confined to left shoulder, throat, jaw, or between the shoulder blades. Others may have shortness of breath or sudden weakness, while approximately 10% may have no symptoms, even when the heart is severely stressed or undergoing a heart attack. Such patients are said to have a defective warning system. Diabetic patients are more prone to have atypical or no symptoms.

  Because there are several causes of chest pain that are unrelated to the heart, many patients tend to ignore their symptoms attributing it to heartburn, mitral valve prolapse, a gall bladder attack, muscle sprain, etc. If you have risk factors for coronary artery disease and are having unusual symptoms suggestive of angina or a heart attack, make sure that you consult your doctor about your complaints.