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Alternative names Return to top
Angina pectoris - stableDefinition Return to top
Angina is a pain or discomfort in the chest or adjacent areas caused by insufficient blood flow to the heart muscle. This chest pain is relieved by rest or medication within a short period of time (usually 15 minutes). Chest pain of a longer duration or pain appearing with a lower level of effort than before, even at rest, should be considered unstable angina.Causes, incidence, and risk factors Return to top
Angina affects approximately 3% to 5% of the population in the U.S. The most common cause is coronary artery disease (CAD).
In CAD, blockages in the coronary arteries, called plaques, prevent an adequate amount of blood from reaching the heart muscle. Situations that require increased blood flow to the heart may cause angina in people with CAD. These include exercise, heavy meals, and stress.
The risk factors for CAD (which in turn causes angina) include the following:
Less common causes of angina include the following:
These conditions may also coexist with CAD.
Symptoms Return to top
A feeling of tightness, heavy pressure, or squeezing or crushing chest pain that:Chest pain or heaviness that is not relieved by three sublingual nitroglycerin tablets under the tongue, each taken 5 minutes apart, or that lasts longer than 15 minutes may represent unstable angina or a heart attack. Call your heart doctor and report to the local emergency room.
Signs and tests Return to top
Your health care provider may note changes in your blood pressure. A heart murmur or arrhythmias (irregular heartbeats) may occur.
An exercise tolerance test (stress test or treadmill test) may show ECG changes associated with the chest pain, which confirm the diagnosis of coronary artery disease in patients with angina.
A stress echocardiogram may show that the heart's ability to squeeze (contract) is altered.
In some circumstances, your health care provider may request a heart scan or an coronary angiography to help assess the condition.
Treatment Return to top
The goals are to reduce symptoms and prevent complications. If you experience angina, rest. If your health care provider recommended that you you take nitroglycerin to relieve the discomfort, do so.
The long-term treatment for stable angina includes nitroglycerin or oral nitrates administered through the skin, aspirin, beta-blockers, and calcium channel blockers. Other medications may also be given to control high cholesterol, high blood pressure, or abnormal heart rhythms.
Your health care provider may recommend a cardiac rehabilitation program to help improve your heart's fitness.
Some patients may need surgery to treat the underlying coronary artery disease. This may include PTCA (balloon angioplasty to a coronary artery). PTCA usually includes placement of a stent, a wire mesh device to help keep the artery open. Another type of surgery is coronary artery bypass grafting (CABG).
Expectations (prognosis) Return to top
Stable angina is usually improved with medical treatment. However, this condition is often a sign of coronary artery disease, which is usually a progressive disease.Complications Return to top
Calling your health care provider Return to top
Call your health care provider if any of the following occur:
Prevention Return to top
If you will be engaging in an activity that may trigger angina, you may take nitroglycerin a few minutes in advance to prevent the pain.
In the long term, the best prevention for angina is to modify as many risk factors for coronary heart disease as possible:
Reducing risk factors, according to some studies, can prevent the progression of arterial blockages and can even lead to a decrease in the severity of blockages, thus markedly reducing angina.
Update Date: 7/20/2004 Updated by: Andrea A. Berger, M.D., Department of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |