John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Angina is one of the serious causes of chest pain. "Angina" is an abbreviation of angina pectoris, a Latin term for "squeezing of the chest." Chest pain is a common symptom caused by many different conditions. Some causes require prompt medical attention, such as angina, heart attack, blood clots in the lungs, or tearing of the aorta. Other causes of chest pain that may not require immediate medical intervention include spasm of the esophagus, gallbladder attack, or inflammation of the chest wall. An accurate diagnosis is important in providing proper treatment to patients with chest pain or acute coronary syndrome.
What is angina, and what are the symptoms of angina?
Angina is chest discomfort that occurs when there is decreased blood oxygen supply to an area of the heart muscle. In most cases, the lack of blood supply is due to a narrowing of the coronary arteries as a result of arteriosclerosis.
Angina is usually felt as:
aching across the chest, particularly behind the breastbone.
This pain often radiates to the neck, jaw, arms, back, or even the teeth.
Angina usually occurs during exertion, severe emotional stress, or after a heavy meal, when the heart muscle demands more blood oxygen than the narrowed coronary arteries can deliver. Angina typically lasts from 1 to 15 minutes and is relieved by rest or by placing a nitroglycerin tablet under the tongue, which relaxes the blood vessels and lowers blood pressure. Both rest and nitroglycerin decrease the heart muscles demand for oxygen, relieving angina.
Angina is classified in one of two types: 1) stable angina or 2) unstable angina.
Stable angina is the most common type of angina, and what most people mean when they refer to angina. People with stable angina have angina symptoms on a regular basis and the symptoms are somewhat predictable (for example, walking up a flight of steps causes chest pain). For most patients, symptoms occur during exertion and commonly last less than five minutes. They are relieved by rest or medication, such as nitroglycerin under the tongue. Stable angina is one of many causes of chronic chest pain.
Unstable angina is less common but more serious. The symptoms are more severe and less predictable than the pattern of stable angina. Pain is more frequent, lasts longer, occurs at rest, and is not relieved by nitroglycerin under the tongue (or the patient needs to use more nitroglycerin than usual). Unstable angina is not the same as a heart attack, but warrants an immediate visit to your physician or hospital emergency department as further cardiac testing is urgently needed. Unstable angina is often a precursor to a heart attack.
Reviewed by Daniel Lee Kulick, MD, FACC, FSCAI on 5/10/2012
Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
Television shows often introduce certain diseases to ramp up the intensity of the plot line and aside from trauma, heart attacks are perhaps the best way to capture the viewers' attention. There is nothing more dramatic than a character clutching their chest while crumpling to the ground. This gets media ratings but in the real world, a heart attack may be considered a failure of preventive medicine.
Heart disease remains the number one killer in the United States, and each case is a potential failure because risk management wasn't aggressive enough. There are five major risk factors for heart disease:
A person can't do anything about the genes he or she inherited, but the other four risks need lifelong vigilance to avoid not only heart attack but also stroke and peripheral vascular disease. All risk factors involve narrowing of the arteries that supply blood to the body and the consequences that occur when organs don't get enough blood and start to fail.
While the patient's history and physical examination are the building blocks
of making a medical diagnosis, the ability to peer inside the body can be a
powerful tool. Ultrasound is an imaging technique that provides th"...