Angina pectoris is a chest pain occurring in the heart muscle that usually occurs during strain, and eases during rest. The pain is a consequence of inappropriate supply of blood to the heart muscle. This is so-called classic or stable angina, the most common one. Some people may develop acute, unstable angina that occurs suddenly, even during rest, showing a sign of warning that there is a serious heart problem.
Angina pectoris can occur both in men and women, although it has slightly lower incidence in women up to the age of 60, which is due to the protective female hormone estrogen. During menopause, as the estrogen level begins to fall, this protection reduces.
The symptoms of angina pectoris may vary, from mild to severe. Usually, they begin during physical activity and disappear when that activity is stopped. Typical symptoms of angina pectoris are:
- uncomfortable feeling of squeezing and pressure in the mid of the chest
- discomfort spreading of the pain to the throat and downwards, or one of the arms (usually the left one)
If this is the first time or if the symptoms become frequent, you have to see a doctor. Having worse symptoms of angina may be a warning that a blood clot has been formed in the artery, which could totally clog the artery and thus cause a heart attack. If the angina pectoris attack lasts long and the pain is intensive, it may be a consequence of an ongoing heart attack.
The most common cause of angina pectoris is coronary artery disease, which is narrowing of arteries supplying blood to the heart muscle. The narrowing is mostly due to build-up fatty plaques on the artery walls, i.e. atherosclerosis. The blood flow in the arteries may be sufficient during rest, but during exercise, it is not. If the supply with oxygen-rich blood is not sufficient, the heart muscle suffers from less oxygen, while toxic substances accumulate in the heart muscle, causing pressure in the chest and cramp-like pain. People with hyperlipidemia, hypertension or diabetes have higher risk of atherosclerosis and angina. The risk is higher if you have a family history or if you are a smoker.
Angina pectoris may occur during temporary spasm of coronary arteries, when arteries narrow for a while, the cause of which may be damaged heart valve, due to which there is less blood supply to the heart muscle.
Anemia can also cause and worsen existing angina. In anemia, the red blood cells have lower capacity to carry oxygen, which affects lower supply of oxygen to the heart.
Stable angina is triggered by physical exercises, but also stress, smoking, cold temperatures, and heavy meals.
The risk factor of angina pectoris are:
- medical conditions like diabetes, coronary artery disease
- high cholesterol, high tryglicerides, high blood pressure
The most serious complication of angina pectoris is heart attack.
Preventive measures can be taken by changing the lifestyle.