Types of angina

There are three kinds of angina:

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Stable angina is brought on by an imbalance between the heart's need for oxygen-rich blood and the amount available. It is "stable" in the sense that the same activities bring it on; it feels the same way each time; and it is relieved by rest and/or oral medications. Stable angina is a warning of heart disease and should be evaluated by a doctor. If the pattern of angina changes, it may progress to unstable angina.

Unstable angina may be a new symptom or a change from stable angina. The angina may occur more frequently, occur more easily at rest, feel more severe, or last longer. Although this angina can often be relieved with oral medications, it is unstable and may progress to a heart attack. Usually more intense medical treatment or a procedure is required. Unstable angina is an acute coronary syndrome and should be treated as an emergency.

Variant angina (also called Prinzmetal's angina or coronary spasm) occurs when a coronary artery goes into spasm, disrupting blood flow to the heart muscle (ischemia). It can occur in people without significant coronary artery disease. However, two thirds of people with variant angina have severe disease in at least one vessel, and the spasm occurs at the site of blockage. This type of angina is uncommon and almost always occurs when a person is at rest, especially while asleep. You are at increased risk for coronary spasm if you: have underlying coronary artery disease, smoke, or use stimulants or illicit drugs (such as cocaine). If a coronary artery spasm is severe and occurs for a long period of time, a heart attack can occur.