Angina pain has specific triggers. Chest pain usually results from physical exertion or emotional stress, and angina pain can often be predicted as individuals learn to recognize triggers. For instance, running to catch a bus or shoveling snow may cause chest pain. Excitement or anger may also trigger angina pain. Angina pain caused by the two "classic" triggers, emotions and exertion, is considered stable angina.

Stable angina pain is usually relieved in two ways. Resting often alleviates chest pain and other symptoms. Angina pain responds well to medication such as nitroglycerin tablets or sprays. Nitroglycerin tablets should be used as soon as chest pain begins.

 

Some people prevent angina attacks by taking nitroglycerin tablets just prior to an event that they know triggers their angina. Nitroglycerin tablets should be used according to your doctor's instructions. Never use nitroglycerin tablets in a manner not advised by your doctor.

Unstable angina refers to angina pain that presents without known chest pain triggers. Unstable angina pain may occur while resting, without any sign of physical or emotional exertion. Chest pain that is more severe than normal angina or has a sudden increase in frequency is typically diagnosed as unstable angina.

 

Unstable angina pain often occurs when an atherosclerotic plaque in a coronary artery ruptures and forms a blood clot. The rupture causes a blockage in the coronary artery, and reduces blood flow to the heart. Patients with unstable angina are at high risk for heart attacks.

Unstable angina is considered a medical emergency. Treatment for unstable angina is almost identical to emergency heart attack treatment. The goal of treatment for unstable angina is to stabilize the patient, alleviate angina pain, and prevent unstable angina from developing into a heart attack. After initial treatment, an exercise test can assess heart function and help guide further treatment decisions.