Munson Health

Back to Document

by Carson-DeWitt R

(Unstable Angina; Stable Angina; Angina Pectoris; Cardiac Angina; Variant Angina)



Angina is usually a sign of coronary artery disease (CAD). It occurs when the blood vessels leading to your heart are narrowed or blocked. The blockage decreases the blood and oxygen flow to your heart. When your heart is deprived of oxygen, you will feel chest pain and other symptoms.
Coronary Artery Disease
Coronary Artery plaque
Copyright © Nucleus Medical Media, Inc.

Stable or Unstable Angina

Angina occurs when your heart's need for blood and oxygen is increased by:
  • Exercise or exertion
  • Cold weather
  • A large meal
  • Emotional stress
Stable angina becomes unstable when symptoms:
  • Occur more often
  • Last longer
  • Are triggered more easily

Variant or Prinzmetal's Angina

This type of angina is usually caused by a spasm of a heart vessel. It may be a sign that you have one of the following conditions:
This type of angina is usually caused by a spasm of a heart vessel. It may be a sign that you have one of the following conditions:

Risk Factors

CAD is more common in older men.
Other factors that may increase your risk of CAD include:


Tests will be done right away to see if you are having an episode of angina or a heart attack. If you have a stable pattern of angina, other tests may be done to determine the extent of your disease. The test results will help to create a treatment plan.
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with blood tests.
Images may be taken of your heart. This can be done with an .
  • Echocardiogram
  • Nuclear scanning
  • Electron-beam CT scan (coronary calcium scan, heart scan, CT angiography )
    • American Heart Association (AHA) guidelines state that heart scans are not for everyone and are most likely to benefit patients at intermediate risk of CAD.
  • Coronary angiography
Your heart activity may be tested. This can be done with:


Family Doctor—American Academy of Family Physicians

National Heart, Lung, and Blood Institute



Canadian Cardiovascular Society

College of Family Physicians of Canada



Dickstein K, Kjekshus J. Effects of losartan and captopril on mortality and morbidity in high-risk patients after acute myocardial infarction: the OPTIMAAL randomised trial. Lancet. 2002;360:752.

Lopez-Sendon J, Swedberg K, et al. Expert consensus document on angiotensin converting enzyme inhibitors in cardiovascular disease. The Task Force on ACE-inhibitors of the European Society of Cardiology. Eur Heart J. 2004;25:1454.

Reenan J. Clinical Pearl: Indications for bypass surgery. Virtual Mentor. February 2004;6:2. Available at: Accessed August 19, 2014.

What is angina? National Heart Lung and Blood Institute website. Available at: Updated June 1, 2011. Accessed August 19, 2014.

7/14/2006 DynaMed's Systematic Literature Surveillance. Available at: Andreotti F, Testa L, et al. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients. Eur Heart J. 2006;27:519-26.


Revision Information