Angina pectoris

Angina pectoris is synonymous with chest pain and occurs due to insufficient supply of oxygenated blood to the heart muscles.

Along with chest pain, one can feel pain in the shoulder, back, arm, neck and even jaw.
The term angina pectoris comes from the Greek terms angor (tightness) and pectus (chest).

Thus, angina means the feeling of tightness in the chest.

Angina is not a disease, but the symptom of coronary heart disease (CHD).
This disease of the coronary artery is caused by deposits of fatty substances on the inner artery walls.
The result is a narrowing of the arteries, which also become more rigid.
This phenomenon is called atherosclerosis or arteriosclerosis.



Angina pectoris can be divided into three types: stable, unstable and variant angina.

Stable or chronic angina
This is the most common form of angina pectoris.
It occurs during activities such as running or walking.
The chest pain usually passes after a short period of rest.
As a rule, chronic stable angina lasts 10-15 minutes and can radiate to other areas of the body such as arms, back and shoulders.

Unstable angina
Unlike stable angina, it does not occur during physical activities.
Unstable angina is a more serious form of the stable type and can occur at different times of the day, even at rest.
The chest pain lasts 10-15 minutes and the symptoms cannot be relieved by medication.
The pain does not follow a regular course and is not predictable. Sometimes it can be a harbinger of an impending myocardial infarction.

Variant angina or Prinzmetal angina
It can occur at night at rest or during sleep. The pain arises from spasms (muscle contractions) in a coronary artery.

Angina can also be divided into:

  1. Spontaneous angina pectoris, when it occurs at rest and without a specific cause.
  2. Exercise sangina, if it occurs as a result of physical activity.
  3. Mixed angina, when it occurs at rest or after physical exertion.

Angina of the esophagus (A. oesophagea) is caused by diseases of the esophagus, for example, gastroesophageal reflux.

Functional angina is caused by diseases that are not related to reduced blood flow to the coronaries.

This disorder includes:

  • aortic stenosis,
  • mitral stenosis,
  • Hyperthyroidism
  • Arrhythmia.


First degree: The pain occurs only with intense or prolonged physical activity.
Second degree: Angina restricts normal daily physical activity.
Third degree: Angina causes a marked restriction of physical activity and occurs even after a short climb of stairs.
Fourth degree: In this situation, the patient feels chest pain during light activities or already at rest.

Difference Between Angina and Heart Attack

Angina occurs when the blood supply to the heart muscle is reduced but not interrupted. This condition manifests itself when the heart muscles do not receive the proper supply of oxygen (or blood) to perform a particular task. The amount of blood that reaches the heart is sufficient for normal activities, but the increased need for oxygen due to increased activity is not guaranteed. During physical exertion, the heart begins to beat faster and needs more oxygen. This can trigger the symptoms of this disease. The chest pain is mild and does not cause permanent damage to the heart muscles.

A heart attack is triggered when the blood supply in a section of the heart muscle decreases. This occurs when the coronary arteries close due to cholesterol deposits. The pain caused by a heart attack is severe. If the blood flow to the heart decreases sharply, irreversible damage to the heart muscle can occur and death can also occur.Effects of angina pectoris in pregnancy

The circulatory system of a pregnant woman must do more to meet the increased demands.
The heart needs to pump more because oxygen consumption is higher.
In pregnant women, the oxygen demand of the heart muscle cannot be satisfied by an altered blood flow due to coronary heart disease.

Angina pectoris is considered an alarm signal of a heart attack and it is extremely important to undergo a thorough examination by the doctor.
Cardiovascular disease is not common in women in pregnancy. However, there are other diseases that alter the balance between oxygen demand and oxygenation.
Anxiety or competitive sports can make the disease worse, so you have to avoid these activities. The doctor may prescribe medications such as calcium antagonists, beta-blockers or nitroglycerin to treat angina pectoris in pregnant women. However, because of the effect on the fetus, doctors need to be careful when prescribing drugs to pregnant women.

Smoking is one of the main factors in acquired coronary artery disease: expectant mothers need to quit smoking.

Chest pain reminiscent of angina pectoris can also occur due to acid reflux or gastrointestinal problems.

Causes of angina

Angina pectoris is caused by insufficient supply of oxygen to the heart muscles. The blood vessels that carry blood to the heart muscles can have a reduced diameter due to deposits of cholesterol.
Another reason is a narrowing of the arteries, as it occurs in the elderly.
Diabetics and overweight people have a higher risk of developing this disease.

Most of the episodes occur during sports, but can also be caused by:

  1. emotional stress,
  2. meals that are difficult to digest,
  3. Temperature fluctuations
  4. Smoke.

Children who feel angina pectoris usually have congenital malformations of the heart, for example, aortic stenosis, which leads to ischemia of the heart muscle (myocardium).
In young people, this can be caused by cocaine abuse.

Symptoms of angina pectoris

With this disease, the main symptoms are:

  • central chest pain,
  • pain radiation into the throat,
  • jaw pain,
  • pain in the arm (especially on the left side),
  • feeling of indigestion,
  • Sweats
  • Fear.

The pain is often described as overwhelming, strong and oppressive. Sometimes you can also get shortness of breath.

Symptoms of angina pectoris in women

One of the most important symptoms is chest pain. In addition, one feels a pressure, heaviness or tightness in the chest. Sometimes the pain may be accompanied by a feeling of burning in the chest, which is often confused with a digestive problem. Here is a list of the most common symptoms of angina pectoris in women:

  • Chest pain behind the sternum
  • Weakness
  • Fatigue

Diagnosis of angina pectoris

A person suffering from frequent episodes of chest pain should consult a doctor immediately.
The most common diagnostic examinations for angina pectoris are:

Blood test

  1. ECG: electrocardiogram
  2. UKG: Echocardiogram

The chest pain can also be caused by other diseases, for example, pneumonia, pleurisy (inflammation of the external pleura), pneumothorax (rupture of the alveoli), etc.

Treatment of angina pectoris and patient management

To prevent chest pain, medications are prescribed.
Drug therapy consists of aspirin, beta-blockers, potassium channel blockers, nitrates and calcium channel blockers. Aspirin helps blood flow freely in the narrowed arteries. Taking beta-blockers lowers arterial blood pressure, while calcium antagonists dilate the arteries. People with elevated cholesterol can take statins (help lower cholesterol levels in the body). Some

If the condition worsens, it may be necessary to undergo surgery to restore the narrowed blood vessels. Surgical procedures include angioplasty and other coronary surgery.

Diet and nutrition

Timely treatment can reduce the risk of a heart attack. In addition, a healthy diet is necessary to prevent angina pectoris.

Those who are under treatment for angina pectoris should avoid eating foods that raise cholesterol and saturated fat.
The diet should consist of fruits, vegetables and foods rich in fiber.
Fish is a necessary food: you should eat salmon, tuna and mackerel.
Meat lovers should choose lean meat or chicken.
Also, eating foods prepared with onions and garlic helps lower cholesterol.

Finally, one should make some lifestyle changes to reduce the complication of atherosclerosis.
One should completely stop smoking and reduce the consumption of alcohol, chocolate, butter, red meat, sugar and fried foods.

How long does the disease last? What is the prognosis?

Life expectancy in angina pectoris depends on the extent of the area affected by ischemia.
If the patient has angina pectoris due to atherosclerosis, the long-term prognosis depends on the extent of atherosclerotic plaques, the cardiac situation and the age of the patient.

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