Heart attack vs. angina: the heart gives warning

The heart is the muscle that pumps oxygen-rich blood to the rest of the organs and tissues. To contract and function properly, the heart muscle (myocardium) also needs a continuous supply of oxygen through the coronary arteries, a kind of plumbing system that, if blocked, can cause problems and even represent a medical emergency.

“When, for some reason, not enough blood reaches a part of the myocardium, 'ischemia' occurs, or a state of distress in the cells that form the myocardium due to a lack of oxygen in the affected area. Angina pectoris and acute myocardial infarction are distinct forms of the same group of cardiovascular diseases, known as 'ischemic heart disease,' and generally, the main cause of these is a significant obstruction of one or more coronary arteries,” explains Dr. Laura Galian-Gay of the Heart Institute at Hospital Quirónsalud Barcelona .

Clogged arteries Classic risk factors are tobacco, cholesterol, diabetes and hypertension

In the case of arteries, this is primarily caused by cholesterol deposits on the vessel walls, in addition to other waste products (lipids, calcium, and inflammatory cells); this deposit is usually progressive, although it can accelerate in the presence of classic cardiovascular risk factors such as smoking, cholesterol, diabetes, and hypertension.

“Both recent angina and a heart attack are major medical emergencies. In particular, heart attack management must be swift and considered a race against time, since the longer it takes to diagnose and treat it, the more cardiac tissue will die irreversibly and the more complications there will be,” Dr. Galian-Gay emphasizes.

Angina pectoris

Specifically, when the state of ischemia is transient and does not cause cardiac cell death, but chest pain does occur, it is called angina. "However, if ischemia is prolonged, it can lead to irreversible cardiac cell death, a condition defined as a 'heart attack,'" the cardiologist explains.

This chest pain, caused by a temporary lack of blood flow and oxygen supply to a portion of the heart muscle, is usually due to a severe narrowing of a coronary artery that isn't completely blocked, she continues. "It's usually triggered by exertion or a stressful situation and is relieved with rest. There's no cardiac cell death," the specialist asserts.

This intense pain, most often described as a feeling of 'tightness or discomfort' in the center of the chest or the pit of the stomach, can extend to the arms (especially the left), the jaw, or the back, sometimes accompanied by shortness of breath, marked anxiety or distress, sweating, dizziness, and paleness.

The heart attack

However, as we mentioned, a myocardial infarction occurs when this death of cardiac cells does occur, caused by a state of prolonged ischemia: “If blood does not reach the myocardium for a certain period of time, this cell death can occur, giving rise to Acute Myocardial Infarction, which can be considered a more acute and severe manifestation than angina pectoris, and in which there is irreversible death of cardiac cells, caused by a complete and sudden occlusion of one or more coronary arteries,” adds Dr. Bruno García del Blanco, interventional cardiologist at the same Heart Institute.

The cardiologist at Quirónsalud Barcelona Hospital explains that the symptoms are similar to those of angina, although in the case of a heart attack, they tend to last longer and are not relieved by rest.

The main symptoms

“The symptoms of an acute myocardial infarction are similar to those of angina, although they are generally more intense, last longer, and do not subside with rest. The typical symptom of a heart attack is a squeezing pain in the center of the chest (like a sensation of a weight in the center of the chest or a fist twisting the heart), sometimes radiating to the jaw, back, or left arm, depending on the location of the infarction and the blocked artery,” emphasizes Dr. García del Blanco.

Symptoms The typical manifestation of a heart attack is a crushing pain in the center of the chest as if a fist were twisting the heart.

In turn, he indicates that there are other "less typical" forms of presentation, especially in diabetic patients, the elderly, or women: "Pain does not always have to be the most bothersome; it can manifest as a sudden feeling of anguish and general malaise, or present with nausea and vomiting for no apparent reason."

For these reasons, the doctor believes it is important that, if sudden and prolonged symptoms suggestive of a heart attack appear, "you should consult an emergency medical service quickly. It is important not to self-medicate and wait and see, as this could delay treatment." The necessary tests will be performed to rule out a heart attack, usually a simple electrocardiogram, and treatment will begin as soon as possible.

A new hemodynamics room

Specifically, Quirónsalud Barcelona Hospital is a pioneer in the treatment of cardiac pathologies and has recently taken a significant step forward in cardiovascular care with the opening of its new catheterization laboratory, which offers state-of-the-art technology to perform diagnostic and therapeutic procedures with greater precision, safety, and efficiency.

Specifically, the new catheterization laboratory has been designed to optimize space and procedures, featuring the Philips Azurion system and ClarityIQ technology. This infrastructure allows for a combination of high-quality, radiation-safe images, greater visibility and precision, while reducing radiation exposure, offering both patients and professionals greater safety.

Furthermore, as part of this advancement, the hospital has successfully implemented the Pulsed Field Ablation (PFA) technique, which has proven to be a more precise and safer option for treating arrhythmias such as atrial fibrillation.