Stable vs. Unstable Angina

Instructor: Justine Fritzel

Justine has been a Registered Nurse for 10 years and has a Bachelor's of Science in Nursing degree.

In this lesson, we will define stable angina and unstable angina. We will review the symptoms of both and how to differentiate between them. We will also review what causes angina.

Angina Pectoris

Most people are aware that the heart is responsible for pumping blood to the rest of the body. The blood supplies oxygen to all cells of the body. Without blood flow, the cells, muscles, and body would die. The heart is a muscle similar to any other muscle in the body, and therefore, it also requires a blood supply to keep it healthy. The arteries carry blood to the heart muscle, and if they are narrowed or blocked, the heart will not get enough blood to it. If the heart muscle is not receiving enough blood flow, it can damage the heart.

Angina pectoris is the medical term for chest pain. Chest pain will occur if the heart is needing more blood flow than it is receiving. This is usually due to narrowed or blocked arteries, which may be a result of plaque build up.

Stable Angina

Dwayne is a 59 year old man with a history of high blood pressure and high cholesterol. Heart disease runs in his family. Dwayne is outside working on his farm today. He is digging out ditches with a shovel. After a few shovels of dirt are cleared, he begins to feel a pain in his chest and has pain down his left arm. He recognizes this pain since he gets it every time he tries to do any physical labor. He is frustrated and angry but stops working and goes inside to rest. Once he's able to sit down on the couch and relax for a few minutes, the pain resolves. Dwayne is experiencing stable angina

In stable angina, a person has narrowed arteries that limit the blood flow to the heart. At rest, the heart is able to get enough blood flow to the heart still. But when the person is active and the heart is working harder- therefore needing more blood flow- the person may experience chest pain. The episodes of chest pain are not a surprise and are consistent in intensity. The chest pain usually lasts a short time and may feel like gas. It can be relieved with rest. Activities that may trigger stable angina include stress, exercise, smoking, and eating heavy meals.

Unstable Angina

A few weeks later, Dwayne is at home watching TV one night. He suddenly has a crushing pain in his chest and feels sweaty. He tries to ignore it but even after 10 minutes, the pain continues and is getting worse. Although he has experienced chest pain before, this is much different and he has an uncanny sense of fear for his well-being. His wife is nearby and notices something isn't right; she immediately calls 911. This time Dwayne is experiencing unstable angina.

In unstable angina, the chest pain usually comes as a surprise and often times while a person is at rest. It lasts longer than stable angina and isn't relieved with rest or medicine. It may get worse as time goes on and it may lead to a heart attack. Unstable angina should be treated as a medical emergency.

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