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Angina vs. heart attacks: What’s the difference?

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AnginaHeart attackDifferencesTreatmentSeeking adviceSummary
A heart attack and angina can both occur when there is reduced blood flow to the heart. But a heart attack causes damage to the heart muscle, while angina does not.
Medically reviewed by Helen Chen MCMSc, PA-C
Written by D. M. Pollock
Updated on

Angina and heart attacks both affect the heart. They happen because of blockages in the arteries that deliver oxygenated blood to the heart muscle.

Both angina and heart attacks can cause chest pain, so it may be hard to tell which you have.

A heart attack, also known as a myocardial infarction, is when this lack of oxygenated blood causes damage to the heart muscle. This is a medical emergency, as the heart muscle begins to die.

Angina is a warning sign that your heart is not receiving enough oxygen. It can be a symptom of an underlying heart condition, such as coronary artery disease (CAD). The pain it causes is temporary, and there is no damage to the heart muscle, unlike during a heart attack.

Knowing which is affecting you can help you to treat the condition effectively.

Sex and gender exist on spectrums. This article uses the terms “female” and “women” when discussing people who are assigned female at birth to reflect language that appears in source materials.

Angina overview

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Angina is a type of pain that you feel in your chest. It happens when your heart is not getting enough oxygenated blood, but it does not cause permanent damage to the heart muscle. This symptom can be a warning sign of an underlying heart condition causing the blood vessels around your heart to narrow or become blocked, such as CAD.

According to the Centers for Disease Control and Prevention (CDC), the most common symptom of CAD in the United States is angina. CAD leads to plaque buildup on the walls of the arteries that supply oxygen to the heart, which then restricts blood flow to the heart. This is known as atherosclerosis.

There are different types of angina, and each has a defining cause. The key types include:

  • Stable angina: These consistent patterns of chest pain occur after exertion or stress for a short time.
  • Unstable angina: Chest pain does not follow a pattern and can occur at rest and last longer. Medication may not help.

Unstable angina is the type of angina that may progress into a heart attack. So, it is a medical emergency.

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Typical symptoms of angina can include:

  • chest pain or pressure behind the breastbone that feels like heaviness, squeezing tightness, or burning
  • discomfort can occur in the arms or shoulders, back, neck, and jaw
  • sweating
  • shortness of breath
  • fatigue or weakness
  • nausea
  • dizziness

Angina may be different in female patients than in male ones. Female patients can experience typical symptoms differently. For example, they may not experience chest pain and tightness.

According to the American Heart Association, female patients are more likely to experience pain in their neck and jaw, nausea, and vomiting.

Heart attack overview

According to the American Heart Association, someone in the United States has a heart attack once every 40 seconds.

Heart attack is a serious condition that can happen when a blockage prevents blood from reaching the heart muscle. This can cause parts of the heart muscle to die.

The coronary arteries deliver oxygenated blood to your heart. Blockages in the coronary arteries develop from a buildup of plaque. Plaque is made up of cholesterol, fat, and cellular waste. Occasionally a blood clot can cause the blockage.

When this happens, blood flow to your heart can decrease or stop altogether. This causes a heart attack.

A heart attack is a medical emergency. You should call 911 right away if you suspect that you or someone you know may be experiencing a heart attack.


The classic symptom of a heart attack is chest pain. But symptoms can vary between individuals. Some common symptoms of a heart attack include:

  • pressure in the chest
  • pain in the chest, back, jaw, and shoulders
  • shortness of breath
  • nausea or vomiting
  • anxiety
  • fast heart rate
  • dizziness

While the most common symptom of a heart attack is chest pain, women are more likely to experience less obvious symptoms, such as:

  • shortness of breath
  • nausea or vomiting
  • upper back pain

Women are also more likely than men not to experience chest pain. Some women experience the feeling of tightness, specifically in their upper back, which feels like a rope squeezing around them.

According to 2018 research, women are more likely than men to think their symptoms are related to stress or anxiety. Both women and healthcare professionals treating women are less likely to think the symptoms are heart-related.

Regardless of sex or gender, if you notice any of the symptoms above, seek help to identify the cause correctly.

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What are the differences?

A heart attack and angina can feel similar. Both cause chest pain, tightness, and shortness of breath, making it hard to tell the difference. This is because both are due to reduced blood flow to the heart muscle.

Angina is a type of pain that occurs when your heart does not receive enough blood. It is a symptom, most often of CAD.

A heart attack is a medical condition that happens when the narrowing of your arteries is so severe that it causes a blockage and damages the heart muscle.

 AnginaHeart attack
Reliefwith rest and medicationno or little relief with rest
Triggersstress and exertionnone
Effect on the heartno damage to the heart muscledamage to the heart muscle


Treatment for angina depends on the severity of your symptoms and the progression of the underlying heart condition causing them.

Some treatments a healthcare professional may recommend include:

  • Lifestyle measures: Exercising regularly, eating a balanced diet, and quitting smoking can help prevent future episodes of angina.
  • Medications: You may need medications to treat underlying health conditions such as hypertension or high cholesterol. A healthcare professional may also prescribe blood thinners like enoxaparin (Lovenox) and warfarin (Coumadin) to prevent blood clots.
  • Surgery: If you have severe narrowing of your arteries, you may undergo a procedure to open blocked arteries. This is angioplasty or a percutaneous coronary intervention (PCI).

Heart attacks require immediate treatment. This typically includes medications to eliminate and prevent more blood clots. It may also include medications to reduce pain, such as aspirin.

You may need a PCI, which is used to unblock arteries blocking blood flow to the heart. A surgeon may insert a stent during this procedure to prevent the artery from closing again.

After a heart attack, a healthcare professional may send you for bypass surgery. This procedure creates new routes for the blood vessels to transport blood to your heart and restore sufficient blood flow.

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When to speak with a professional

If you experience any persistent chest pain, you should call 911 immediately. If you are having a heart attack, the faster you receive treatment, the better your outcome may be.

If you do not have a diagnosis of angina and experience intermittent chest pain that stops when you rest, you should seek advice from a healthcare professional.

If your symptoms of angina get increasingly worse, happen more frequently, or are different in any way, you should speak with a healthcare professional.


Angina and heart attacks both result from restricted blood flow to the heart muscle. Heart attacks occur due to the loss of blood flow to the heart muscle, causing damage. Angina does not cause damage to the heart muscle, and you may be able to relieve symptoms by resting.

If you suspect you are having a heart attack, seek immediate medical attention and call 911.

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