One autumn morning when the temperature dropped noticeably, a 50-year-old office worker, Mr. A, felt a sudden chest pain on his way to work.

He felt a tight, aching sensation in the center of his chest, but he thought it was just indigestion from the chicken he had eaten as a late-night snack the day before. Rubbing his epigastric (pit of the stomach) area and resting for a moment made the pain subside, and Mr. A brushed it off as no big deal.

However, a few days later while climbing the stairs to his home after work, a stronger pressure than before gripped his entire chest, and the pain radiated to his jaw and left shoulder.

As cold sweats broke out, Mr. A had his family call 119 and visited a nearby emergency room. Upon examination, he was diagnosed with angina pectoris and is currently receiving treatment.

Angina occurs when the coronary arteries supplying blood to the heart narrow, preventing a sufficient supply of oxygen to the heart muscle.

In particular, because symptoms do not always manifest solely as chest pain, it is easy to mistake them for indigestion or fatigue. If symptoms repeat or become stronger than before, caution is needed as they may be signs of coronary artery disease.

The most common symptom is tightness or a squeezing pain in the center of the chest. Patients often describe it as a chest-pressing or suffocating sensation.

The pain does not always stay in the chest; like Mr. A, some experience pain radiating to the jaw and shoulders, or discomfort in the upper abdomen and shortness of breath.

Angina is largely divided into stable, unstable, and variant types. Stable angina occurs when stress is placed on the heart—such as walking or climbing stairs—and improves with rest.

Unstable angina is characterized by pain occurring even during rest, or an increase in the frequency and intensity of pain compared to before. It requires prompt treatment as it can progress to an acute myocardial infarction (heart attack).

Variant angina occurs when a coronary artery temporarily goes into spasm and narrows. It often occurs at specific times such as dawn or early morning, and can be triggered by cold temperatures, stress, or smoking.

Suspect Cardiovascular Disease if Chest Pressure Repeats, Worsens, or Fails to Improve with Rest

Not all chest pain means angina. However, if a newly developed chest pressure repeats, progressively worsens, or does not improve with rest, the possibility of cardiovascular disease must be checked.

The same applies when shortness of breath, cold sweats, or dizziness occur together. If chest pain continues for several minutes even after resting, you should avoid driving yourself and call 119 to quickly seek an emergency room.

When chest pain is present, electrocardiograms (ECGs) and blood tests are used to diagnose myocardial ischemia or myocardial infarction, and troponin levels—which rise when heart muscle is damaged—can also be checked.

However, for angina patients, an ECG can appear normal during times without symptoms, so it is important to get tested quickly when symptoms are active.

Depending on necessity, echocardiography, cardiac CT, or coronary angiography are additionally performed to check heart structure and function, coronary artery status, and the degree of vascular stenosis.

Treatment is decided by reviewing symptoms, the degree of vascular stenosis, and accompanying conditions. Depending on the angina type, medication may include antiplatelet agents to inhibit blood clot formation and beta-blockers to reduce the heart's oxygen demand.

Additionally, vasodilators to relieve symptoms and drugs to lower cholesterol and stabilize atherosclerotic plaques can be used. If the blood vessels are severely narrowed or symptoms are difficult to control with medication alone, coronary intervention (stenting) or coronary artery bypass graft surgery (CABG) may be performed.

Sometimes, people delay hospital visits, attributing chest pain to temporary indigestion or fatigue. If pain repeats, becomes stronger than before, spreads to the jaw, shoulders, or arms, or is accompanied by shortness of breath and cold sweats, you must suspect cardiovascular disease and seek medical attention promptly.

Diabetic patients and the elderly need even more caution because their symptoms may appear as chest discomfort, shortness of breath, or indigestion rather than typical chest pain. If unusual chest discomfort suddenly arises or persists, you must not judge it arbitrarily; instead, immediately determine the exact cause at a nearby emergency room and receive emergency care.

After being diagnosed with cardiovascular disease, management is paramount. Since smoking and excessive drinking are major risk factors, quitting smoking and moderating alcohol intake are top priorities. Conditions that promote arteriosclerosis—such as hypertension, diabetes, and dyslipidemia—must also be managed steadily.

For meals, a diet centered around vegetables and whole grains while reducing sodium, saturated fat, and refined sugars is recommended. While exercise is important for cardiovascular health management, if you already have angina symptoms or a cardiovascular diagnosis, do not start arbitrarily; discuss with medical staff to determine the intensity and method.

On cold days, it is necessary to avoid sudden outdoor activities or excessive exercise, and to perform sufficient warm-up exercises.

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