An estimated 10 million Americans suffer from angina pectoris, and in 2022, another half million will develop it. Angina is another way of saying chest pain or chest pressure. It's a symptom of coronary artery disease (CAD), which is sometimes also known as ischemic heart disease, and it typically affects men over the age 45 and women over 55. So, why do we get it? Angina occurs usually because one (or more) of the heart's arteries are blocked in some way (this is "ischemia").
Diabetes presents an additional risk factor for angina, even if blood glucose levels are managed. The ADA says that those with diabetes are twice as likely to suffer from a heart attack or stroke as those without.
Angina often feels like an uncomfortable pressure in the chest, but it can also show up as discomfort across the neck, jaw, back, or arm.
Women and men can experience angina differently. Women are more likely to have throat and jaw discomfort, abdominal pain, indigestion, nausea, or shortness of breath. Some researchers think the difference in symptoms may be because men usually have CAD while women sometimes have microvascular disease (MVD), or "small artery disease," heart disease that affects the tiny blood vessels that branch out from the larger coronary arteries.
There are two main types of angina: "stable" and "unstable." Stable angina comes and goes—typically during exercise, manual labor, physical exertion, or stress. This kind can be treated. At the other end of the scale, as the name suggests, unstable angina occurs suddenly, and often during rest. Unstable angina can lead to a heart attack—for this reason, it's considered a medical emergency.
Stable and unstable angina often hit when the heart requires more blood than it's receiving. As mentioned, this can be triggered by physical exertion, but it's important to know that it can also be brought on by strong emotions or stress. If the arteries are narrowed, it's possible no (or little) discomfort will be experienced in situations where there's low demand for oxygen, such as when sitting. But the second the heart has to work harder, such as with running or climbing, that's when the pain is likely to hit. The same holds true for emotional situations, which is why doctors recommend stress management for those suffering from angina.
Another type of angina is variant angina, also called "Prinzmetal's angina," "angina inversa," or "vasospastic angina." Variant angina usually occurs when the sufferer is at rest, mostly between midnight and the early hours of the morning. And it usually affects younger patients. Variant angina is caused by a severe spasm in the coronary arteries, usually brought on by stress, cold, smoking, medicines, or drug use. While rare (typically, 2 cases out of every 100), the pain or discomfort brought about by this type of angina can be severe.
The first step in diagnosing angina will most likely be an electrocardiogram (ECG) to work out what kind of testing you will need for your cardiologist to confirm angina. If you're able to exercise, then your doctor will often give you a standard exercise stress test (treadmill or similar) to determine how your heart is doing. Alternatively, heart imaging will give your doctor information about the levels of blockage in your arteries. Different types of cardiac imaging include echocardiograms, PET scans, or nuclear stress tests. Another option to see if there's a restriction in blood flow in the heart is a coronary angiogram, which is like an x-ray of your coronary arteries.
The Social Security Administration ("Social Security") frequently sees angina on applications for Social Security and SSI disability. While Social Security actually requires you to have angina to qualify for disability benefits for coronary artery disease, having angina alone will not result in an award of disability benefits.
According to Social Security's disability listing for ischemic heart disease, a disability applicant with angina also has to have had one of the following:
Most individuals with coronary artery disease fulfill the imaging requirement by having an angiogram showing a partial "occlusion," or blockage, in a main artery (for example, right coronary artery, left anterior descending artery, or circumflex artery) that is at least a certain percentage (for example, 70%) blocked. For details on the exact requirements, see our article on getting disability benefits for coronary artery disease.
An easy way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. You may also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information, please see our article about applying for Social Security disability benefits.
If you have questions or you'd like help with your application, you can try to get a free phone consultation with a disability lawyer or advocate to evaluate if your symptoms qualify for benefits. Disability representatives collect a one-time fee only if you win benefits (for a maximum of 25% of your backpay).
Updated December 30, 2021