Introduction
Myocardial Infarction and Stable Angina are both heart-related and share common risk factors. Myocardial Infarction is a severe condition that causes heart muscle damage due to blocked arteries. Stable Angina, on the other hand, is a less severe condition and causes chest pain during physical activity. Both of them can result from narrowed coronary arteries due to cholesterol build-up. One common symptom tends to be chest discomfort.
Despite the given similarities, Myocardial Infarction and Stable Angina differ significantly. Myocardial Infarction, colloquially known as a Heart Attack, is a medical emergency. Stable Angina is considered to be a less severe form of chest pain during exertion. Prompt medical attention is crucial for myocardial infarction, while Angina often responds to rest.
Myocardial Infarction vs. Stable Angina
The key difference between Myocardial Infarction and Stable Angina lies in the extent of heart muscle damage. Myocardial Infarction causes severe damage. This happens due to the complete blockage in the coronary arteries. Hence, it is a medical emergency. In contrast, Stable Angina is a result of partial blockage in the arteries. It causes temporary chest pain during exertion. This differentiation is crucial and requires recognition as the severity and need for immediate medical attention varies in both. Myocardial Infarction requires immediate medical intervention. It can turn out to be life-saving if timely action is taken. On the other hand, Stable Angina typically improves with adequate rest and medication and is manageable with lifestyle changes.
Difference Between Myocardial Infarction and Stable Angina in Tabular Form
| Parameters of Comparison | Myocardial Infarction | Stable Angina |
| DEFINITION | It refers to a severe heart attack that may cause permanent heart muscle damage. | It refers to chest pain induced by a temporary reduction of blood flow. It causes no last longing damage. |
| COMMON NAME | It is commonly referred to as a “Heart Attack”. | It is commonly referred to as “Chest pain”. |
| CAUSES | Stable Angina is caused by partial blockage of coronary arteries. | Stable Angina is caused due partial blockage of coronary arteries. |
| OCCURRENCE OF PAIN | It can occur at any time. | It occurs when engaged in strenuous physical activity or due to emotional stress. |
| SYMPTOMS | The symptoms include chest pain with damage to the heart. Sudden pain can be felt in the substernal chest. That pain radiates to the left side of the neck. It is usually described as severe, steady, and crushing. Some symptoms also include hypotension, weak rapid pulse, and low-grade fever. | The pain usually lasts for less than 15 minutes. The following discomfort is usually transient and lasts for 3-5 min. |
| SEVERITY | It is considered to be a critical medical emergency. | It is said to be less severe and manageable. |
| RISK OF HEART DAMAGE | There is a high risk of permanent damage to the heart. | There is a low risk of permanent heart muscle damage. |
| RELIEVING FACTORS | There are retained symptoms after 15 minutes and are not relieved by rest. | The symptoms are relieved by rest within 10-15 minutes. The lack of relief indicates that the individual may be developing infarction. |
| DURATION | The pain usually lasts for more than 15 minutes. | Procedures like angioplasty or stent placement and clot-dissolving drugs can be beneficial in cases of Myocardial Infarctions. |
| TREATMENT | Procedures like angioplasty or stent placement, and clot-dissolving drugs can be beneficial in cases of Myocardial Infarctions. | Prescribed medications and some changes in lifestyle can be beneficial in Stable Angina. In severe cases, Angioplasty is advised. |
What is Myocardial Infarction?
Myocardial Infarction refers to a life-threatening heart condition that occurs when the blood cannot reach some parts of the heart due to blocked blood vessels. This blockage can develop due to increasing cholesterol and cellular waste products in the arteries. It can also take place due to the formation of sudden blood clots that interrupt the blood flow. This deprives the body of oxygen supply. It is crucial to seek immediate medical attention in times of a heart attack to save lives.
Types of Myocardial Infarction
ST-Segment Elevation Myocardial Infarction (STEMI): ST-elevation myocardial infarction, or STEMI, is a heart attack condition wherein a major artery feeding into the heart is completely blocked. This changes the direction of blood flow toward the organs, and the electrical current is directed toward the lower chambers. It causes central chest pain, which is heavy and pressure-like in nature.
Some types of STEMI include –
- Anterior STEMI: It refers to a blockage in the artery that supplies blood to the front wall of the heart called the left anterior descending (LAD) artery.
- Interior or Lateral STEMI: It refers to a blockage in the arteries that supply blood to the bottom walls of the heart. This type of STEMI can be caused by the blockage of the right coronary artery (RCA).
- Posterior STEMI: It refers to a blockage in the arteries that supply blood to the back wall of the heart.
Non-ST-Segment Elevation Myocardial Infarction (NSTEMI): Non-ST-Segment Elevation Myocardial Infarction, or a Non-STEMI, is another type of heart attack in which either the minor coronary artery is completely blocked or the major coronary artery is partially blocked. The symptoms can be of a classic heart attack but tend to inflict less damage to heart muscle.
The treatment of NSTEMI focuses on restoring blood circulation and preventing the formation of blood clots. The medications and measures involve beta-blockers, statin drugs, and blood thinners such as Aspirin or Plavix (Clopidogrel). Post stabilizing the patient, the cardiologist then determines if the patient needs further treatment.
Classic Symptoms
Some common symptoms experienced during a heart attack are as follows-
- Chest Pain: The majority of people who have experienced a heart attack state a feeling of chest pain. They describe it as a sense of fullness or tightness. Some others feel the sensation of a knot or weight in the chest. It might feel like a dull but steady ache or a sharp pain that may come and go.
- Shortness of Breath: During a heart attack, a feeling of pressure in the chest can make it hard to breathe.
- Stiffness or Numbness in the upper body: Individuals describe stiffness in one (left) or both arms, the back, shoulders, neck, jaw, or upper abdomen.
- A cold sweat: Cold sweating is a common symptom that may occur as a response to stress. The body sends the brain signals that it's being threatened in some way. It turns out to be a fight-or-flight situation, leading to stress.
Some other symptoms also include fatigue, nausea, vomiting, fainting, stomach discomfort, heartbeat changes, and a blue tint to the lips, hands or feet.
Treatment
The treatment of Myocardial infarction involves restoring blood flow to the heart muscles at the earliest. This can be achieved in several ways – using medication and surgery. Standard treatment options include-
- Supplementary Oxygen: Heart attack causes low levels of blood oxygen and breathing problems. Supplementary oxygen is provided with a tube or a mask covering the mouth and nose. It is the easiest way to increase blood glucose levels and reduce strain on the heart.
- Medications: Several medications may be given to a heart attack patient, including Anti-clotting medicines, Thrombolytic medicines, Nitroglycerin, Pain medications, and Anti-arrhythmia medications
- Percutaneous Coronary Intervention: This myocardial infarction treatment is given to restore circulation of the heart muscle. It involves placing a stent at the blockage site to keep the artery open and avoid another blockage.
- Coronary Artery Bypass Grafting: People with severe blockages in their coronary arteries may be advised to undergo a coronary artery bypass grafting procedure. Commonly known as open-heart surgery, CABG, or bypass surgery, it involves using another blood vessel harvested from another part of your body to construct a detour for the blood to pass through.
What is Stable Angina?
Stable Angina refers to chest pain that is triggered by strenuous physical activity and relieved with appropriate rest. A permanent myocardial injury does not occur.
Stable Angina is caused by an imbalance between myocardial oxygen supply and demand, resulting in symptoms of chest pain and shortness of breath during exertion when the demand outweighs the coronary blood supply.
Classic Symptoms
The symptoms of Stable Angina include –
- Shortness of breath
- Nausea
- Fatigue
Some people with Angina might not have typical chest pain symptoms. The discomfort experienced by them may be mild and relatively easier to brush off as something not to worry about.
While some people may not experience the symptoms at all, some others may feel slight discomfort in their back, abdomen, shoulders, jaw, and arms. In some other cases, nausea and breathlessness may be their only symptom.
Risk Factors
People with one or more risk factors for coronary artery disease, especially middle-aged or older ones, should never ignore any symptoms and must seek medical attention at the slightest possibility of visible symptoms.
Risk factors of CAD include-
- Advancing age
- Smoking or using tobacco products
- High cholesterol
- High blood pressure
- Diabetes
- Overweight or obesity
- Sedentary lifestyle
- Having a family history of coronary artery disease at a young age (younger than 45 in men and 55 in women)
Treatment
To treat Stable Angina, treatment options like lifestyle changes, medications, and surgeries must be considered to prevent further progression of the same. Here, we will delve into these options in detail.
Lifestyle Changes: Stable Angina can be treated with recommended lifestyle changes. Following a heart-healthy lifestyle can help reduce the progression of Angina. Some of these lifestyle changes include –
Following a healthy eating plan and limiting alcohol.
- Aiming for a healthy weight.
- Being physically active (based on your healthcare provider's recommendations) on triggers angina.
- Managing stress
- Quitting smoking
- Getting enough good-quality sleep
Medication: Stable Angina is usually relieved with rest. Nitroglycerin also proves t be a beneficial medication for angina patients. Other medications prescribed to reduce Angina and treat high blood pressure or cholesterol include-
- Beta-blockers
- Calcium channel blockers
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers
- Statin medications
- Blood thinners
Surgery: Surgery is considered for someone suffering from stable Angina only when medications do not adequately control the visible symptoms.
There are two main types of surgery for Angina-
- Coronary artery bypass graft (CABG): In this surgery, a section of blood vessels is taken from another part of the body and used to reroute blood around the blocked or narrow section of an artery.
- Coronary angioplasty and stent insertion: In this surgery, a narrowed section of the artery is widened using a tiny tube called a stent. The stent remains in the artery to avoid further closure of the artery.
Main Differences Between Myocardial Infarction and Stable Angina in Points
- Myocardial infarction is severe with permanent heart muscle damage, while stable Angina is less severe, causing temporary chest pain.
- Heart attack has complete artery blockage, but Angina involves partial blockage.
- Heart attack pain is severe and prolonged; angina pain is temporary, triggered by physical activity.
- Heart attack carries a higher risk of heart muscle damage than Angina.
- Heart attack needs immediate medical attention; Angina often improves with rest.
- Heart attack shows ST-segment elevation; Angina may show ST-segment depression or T-wave inversion.
- Heart attack has higher cardiac enzyme levels; Angina may show slight elevation.
- Heart attack requires urgent procedures; Angina is managed with meds and lifestyle changes.
- Heart attack has higher mortality; Angina has a better long-term prognosis.
- Heart attack needs intensive medical care; Angina can be controlled with medications.
Conclusion
To conclude, Myocardial Infarction and Stable Angina are distinguished mainly based on the extent of heart damage. Myocardial Infarction results in severe chest pain and permanent harm due to blockage in the coronary artery. Contrarily, Stable Angina is comparatively less severe and causes temporary chest pain. Also, the muscle harm does not last long. While heart attacks require immediate medical attention, Angina often heals with appropriate rest and prescribed medications. Their distinct levels of severity also contribute to their differences. A proper understanding of both will ensure better outcomes for individuals who are at risk of such heart conditions.
References
- https://www.tutorialspoint.com/
- https://www.verywellhealth.com/
- https://www.metropolisindia.com/
