Angina (Chest Pain) Types

---

The different types of angina are identified based on cause or whether medicine or rest improves symptoms. Symptoms vary depending on the type of angina you have.

Stable angina is the most common type of angina in the United States. It follows a pattern that has been consistent for at least 2 months. That means the following factors have not changed:

• How often your angina events occur
• What causes or triggers your angina
• How long your angina events last
• How well your angina responds to rest or medicines

If you have stable angina, you can learn its pattern and predict when an event will occur, such as during physical activity or mental stress. The pain usually goes away after you rest for a few minutes or take your angina medicine.

Tell your healthcare provider right away if you notice changes in the pattern of your angina, such as when pain lasts longer or happens more often. Pattern changes may be a sign that the condition causing your angina is getting worse. If this happens, stable angina can become unstable angina.

Unstable angina does not follow a pattern. It may be new or occur more often and be more painful than stable angina. Unstable angina can occur with or without physical exertion. Rest or medicine may not relieve the pain.

Unstable angina is a medical emergency because it can progress to a heart attack. You may need medical attention right away to restore blood flow to your heart muscle.

Microvascular angina can be a sign of coronary microvascular disease, a type of coronary heart disease affecting the tiny arteries of the heart. Microvascular angina events can be stable or unstable, and they can be more painful and last longer than other types of angina. Symptoms can occur during exercise or rest. Medicine may not relieve the pain.

Vasospastic angina, also known as Prinzmetal angina or variant angina, is not very common. It occurs when a spasm — a sudden tightening of the muscles within the arteries of your heart — causes the arteries to narrow temporarily. A spasm of the coronary arteries can block blood flow to the heart and cause serious pain. This type of angina usually happens while you are at rest, between midnight and early morning, and in a pattern. Medicine can ease symptoms.

Refractory angina occurs when angina symptoms cannot be managed with medicine or with other treatments, such as placing a stent.