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Is it Angina or a Heart Attack? Here's How to Tell

Medically reviewed by Mia Dacumos, MD · Nephrology · Makati Medical Center

Written by Jan Alwyn Batara · Updated Jun 10, 2021

Is it Angina or a Heart Attack? Here's How to Tell

When it comes to finding out what is causing chest pain, it can get very tricky. For example, if you compare unstable angina vs heart attack, the symptoms can be very similar, especially since unstable angina can sometimes lead to a heart attack.

But what exactly is unstable angina, and why does it precede a heart attack? Should you be concerned if you experience unstable angina? And what are the main differences between unstable angina vs heart attack?

Before we get to the difference between an unstable angina vs heart attack, we need to first talk about what an angina is and what causes it to happen. 

What is angina?

Angina is characterized as a feeling of pain, discomfort, or tightness around the chest.

It can also sometimes feel like indigestion, and the discomfort can spread to your shoulders, arms, neck, jaw, and even your back.

unstable angina vs heart attack

Angina itself is not a disease, but it could be a symptom of a heart problem.

An angina is usually caused by buildup of plaque in the arteries blocking the flow of blood to the heart. Because of this, the heart tries to compensate for the lack of blood and oxygen by pumping faster, which causes the heart to exert itself.

There are four main types of angina.

  • Angina pectoris or stable angina – this type of angina usually happens when a person is exerting themselves, such as during exercise or intense physical activity. This typically lasts a short time.
  • Unstable anginaunstable angina can happen even when a person is not engaged in any physical activity. It can last longer than stable angina, and usually does not go away with medicine. It can be considered a medical emergency since unstable angina usually precedes a heart attack.
  • Prinzmetal’s angina – this type of angina happens when a person is resting, and the symptoms can be very severe. But unlike unstable angina, medication usually makes this type of angina go away.
  • Microvascular anginamicrovascular angina is caused by spasms within the heart’s smallest blood vessels, causing reduced blood flow to the heart.

Most of the time, angina is not a serious cause for concern. However, angina means that you might have a heart problem that needs to be managed before it gets worse.

Though, in the case of an unstable angina, it can be dangerous, and thus requires medical treatment.

What are the Pre-Warning Signs of a Heart Attack?

Unstable Angina vs Heart Attack: What Are Their Differences?

The symptoms of unstable angina vs heart attack are very similar, and it is not uncommon for an unstable angina to happen before a heart attack.

The main difference between unstable angina vs heart attack is that in an unstable angina, blood flow to the heart is restricted, but not blocked completely.

In contrast, a heart attack occurs when blood flow is completely blocked, and thus it is a more serious condition.

During unstable angina, a blood clot usually restricts the flow of blood inside an artery. However, the blood clot can quickly grow larger, and in time, can completely block the artery, causing a heart attack.

Unstable angina should never be ignored, and if you experience one, it would be best to seek medical assistance immediately. 

What are the symptoms of unstable angina?

Here are some of the symptoms of an unstable angina that you need to watch out for:

  • A feeling of pain or tightness in your chest
  • It usually comes unexpectedly and occurs even if you are at rest
  • Taking your regular angina medicine does not make it go away
  • Resting also does not take a way the symptoms
  • It lasts much longer than a stable angina, usually about 30 minutes
  • The symptoms can also get worse over time

What are the symptoms of a heart attack?

Here are the symptoms of a heart attack:

  • Chest pain
  • Irregular heartbeat or arrhythmia
  • Sweating
  • Lightheadedness or dizziness
  • Shortness of breath
  • Feeling nauseated or wanting to vomit
  • Pain in the back, neck, jaw, upper abdomen, or in one of your arms

If we compare the symptoms of unstable angina vs heart attack, you will see that the major symptoms can be similar. In fact, unstable angina can sometimes be mistaken for a silent heart attack.

But regardless of whether or not you are experiencing unstable angina vs heart attack, both should be considered medical emergencies.

It is important to seek treatment as soon as possible in order to prevent it from happening again.

Lifestyle Changes to Improve Your Heart Health

What can you do to lower your risk of angina?

Here are some things you can do that can help you lower your risk of angina:

  • Eat a healthy diet that is rich in fruits, vegetables, and fish, and lower your consumption of meat, fatty foods, and processed foods.
  • Engage in at least 30 minutes of exercise daily.
  • If you are overweight or obese, it would be a good idea to try and lose weight and get as close to your ideal weight as possible.
  • If you are a smoker, it is important to quit smoking. Not only does smoking increase your risk of angina and heart disease, it also increases your risk of lung cancer and other serious illnesses.
  • Drink alcohol moderately, or if possible, stop drinking. Ideally, men should have one to two drinks per day, and women should have one drink per day.
  • Stress can also cause damage to your heart. So if you find yourself constantly stressed out, be sure to take some time to relax and lower your stress levels.

Learn more about Heart Health, here. 


Hello Health Group does not provide medical advice, diagnosis or treatment.

Medically reviewed by

Mia Dacumos, MD

Nephrology · Makati Medical Center

Written by Jan Alwyn Batara · Updated Jun 10, 2021

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