Angina and Heart Attack: What's the Difference?

Medically Reviewed By William C. Lloyd III, MD, FACS
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Man with chest pain
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Someone who is having chest pain is likely to think it's a heart attack. While this could very well be true, the source of the pain might be something else. Angina could be the cause.

Angina and heart attack share some signs and symptoms. For instance, with either you can have pain that feels like pressure or squeezing in your chest. You also might feel the discomfort elsewhere in your body. For both, the cause is often coronary artery disease. However, these two heart conditions are not the same. For one thing, a heart attack causes permanent damage. Angina does not. Angina could be a warning sign of a heart attack, but you can have angina without having a heart attack.

Here is what you should know about these two heart conditions.

Causes

Your heart muscle needs oxygen-rich blood to keep working. Oxygen comes to the heart through blood vessels called coronary arteries. However, a waxy substance—or plaque—can build up on the inside wall of an artery. Over time this narrows the artery, allowing less blood to flow through the vessel. This condition is coronary artery disease.

Angina is the chest pain you feel because your heart muscle isn’t getting enough blood. It's a symptom of coronary artery disease. There are two main types of angina:

  • Stable angina is chest pain that occurs when your heart is working hard and needs more oxygen. The flow of blood can't keep up with the demand. This type of angina goes away when you rest or take medication.

  • Unstable angina is chest pain that happens even when your heart is not working hard. This type of angina may be a warning sign of a heart attack.

A heart attack occurs when the flow of blood through a coronary artery is blocked. This can happen when a plaque breaks open and a blood clot forms over the break. The clot blocks blood flow to the heart muscle.

A heart attack needs immediate treatment. Call 911 and get to an emergency room. Quick treatment may prevent permanent damage to your heart. Untreated heart attack can lead to cardiac arrest, which occurs when your heart stops beating.

Signs and Symptoms

Some signs and symptoms of angina and heart attack are similar. These include:

However, there are also important differences including:

  • Signs and symptoms of stable angina occur only when your heart is working harder than normal. Resting or taking heart medication will make the pain go away. The pain is usually familiar because you have experienced it before.

  •  Signs and symptoms of unstable angina or a heart attack occur when you're resting. They may even occur when you're asleep. The signs and symptoms may be more severe. Most important, they do not get better with rest or medication, and may get worse.

Response

The most important difference between having angina and having a heart attack is how you need to respond. Stable angina may not be an emergency. If you have been diagnosed with stable angina, your symptoms may go away with rest and medication. However, you should call your doctor if the signs and symptoms seem different, are more frequent or last longer than usual. If you have never had angina and you have signs and symptoms that go away with rest, call your doctor right away.

Signs and symptoms of unstable angina or a heart attack need emergency treatment. These symptoms do not go away with rest and may get worse. Do not drive to the hospital. Call 911 and wait on the phone until help arrives.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Apr 10
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