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.
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
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
- 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
- Tiredness (fatigue)
- Feeling faint
Angina chest pain is usually
relieved within a few minutes by resting or by taking prescribed cardiac medicine, such
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
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.
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.
MRI. This test can look at the amount of blood flow to the heart
muscle. It may not be available at all medical centers.
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