Angina Pectoris

What is angina pectoris?

Angina pectoris is chest pain or
discomfort that occurs when a part of your heart doesn’t get enough blood and oxygen. It
is most often just called angina. Angina can be a symptom of coronary artery disease
(CAD). But it can have other causes.


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What causes angina pectoris?

Angina pectoris occurs when your
heart muscle (myocardium) does not get enough blood and oxygen. Not enough blood supply
is called ischemia.

Angina can be a symptom of coronary artery disease (CAD). This is
when arteries that carry blood to your heart become narrowed and blocked. This can
happen because of:

  • Hardening of arteries (atherosclerosis)
  • A blood clot
  • Plaque in an artery that can rupture (unstable plaque)
  • Poor blood flow through a narrowed heart valve
  • Lessened pumping of the heart muscle
  • Coronary artery spasm

There are 2 other forms of angina pectoris. They are:

  • Microvascular angina. This
    used to be called Syndrome X. It causes chest pain with no coronary artery blockage.
    The pain is caused by from poor function of tiny blood vessels that lead to the
    heart, arms, and legs. It is more common in women.
  • Variant angina pectoris. This
    is also called Prinzmetal’s angina. It is rare. It occurs almost only at rest, not
    after exercise or stress. It usually occurs between midnight and 8 a.m. It can be
    very painful. It is related to spasm of the artery. It is also more common in
    women.

Who is at risk for angina pectoris?

Anything that causes your heart
muscle to need more blood or oxygen can result in angina especially if you already have
a blockage or narrowing. Situations that may trigger angina include:

  • Physical activity
  • Emotional stress
  • Extreme cold or heat
  • Heavy meals
  • Drinking too much alcohol
  • Cigarette smoking

What are the symptoms of angina pectoris?

These are the most common symptoms
of angina:

  • A pressing, squeezing, or crushing
    pain, usually in the chest under your breastbone
  • Pain that may also occur in your upper
    back, both arms, neck, or ear lobes 
  • Chest pain that spreads to your arms,
    shoulders, jaw, neck, or back
  • Shortness of breath
  • Weakness
  • Tiredness (fatigue)
  • Feeling faint

Angina chest pain is usually
relieved within a few minutes by resting or by taking prescribed cardiac medicine, such
as nitroglycerin.

How is angina pectoris diagnosed?

Your healthcare provider will ask
about your medical history. He or she will give you a physical exam. A healthcare
provider can often diagnose angina from symptoms and how and when they occur. You may
also have tests such as:

  • Electrocardiogram (ECG). This test records the electrical activity of
    the heart. It shows abnormal rhythms (arrhythmias). And it detects heart muscle
    damage.
  • Stress
    test.
     This is done while you exercise on a treadmill or pedal a
    stationary bike. The test checks your heart’s ability to function when under stress
    such as exercise. Breathing and blood pressure rates are also watched. A stress test
    may be used to find coronary artery disease. Or it may be done to find safe levels of
    exercise after a heart attack or heart surgery. A type of stress test uses medicine
    to stimulate the heart as if you were exercising. An exercise treadmill test only
    uses an ECG to evaluate for ischemia. A stress echocardiogram uses an ECG and
    ultrasound pictures of the heart. A nuclear perfusion stress test uses an ECG and
    radioactive tracer detected by a nuclear camera.
  • Cardiac
    catheterization.
    A wire is passed into the coronary arteries. Then a
    contrast dye is injected into your artery. X-ray images are taken to see the
    narrowing, blockages, and other problems of certain arteries.
  • Cardiac
    MRI.
    This test can look at the amount of blood flow to the heart
    muscle. It may not be available at all medical centers.
  • Coronary CT
    scan.
    This test looks at the amount of calcium and plaque inside of
    the blood vessels of the heart. It can also show blood flow through the coronary
    arteries.