Angina pectoris - stable

Alternative names

Angina - stable

Definition

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

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:

• Male gender
  
• Cigarette Smoking
  
• High Cholesterol levels (in particular, high LDL and low HDL cholesterol)
  
• High blood pressure (hypertension)
  
• Diabetes
  
• Family history of Coronary heart disease before age 55
  
• Sedentary lifestyle
  
• Obesity
  

Less common causes of angina include the following:

• Coronary artery spasm (also called Prinzmetal's angina)
  
• Diseases of the heart valves
  
• Heart failure
  
• Abnormal heart rhythms
  
• Anemia
  

These conditions may also coexist with CAD.

Symptoms

A feeling of tightness, heavy pressure, or squeezing or crushing chest pain that:

• is under the breastbone or slightly to the left
  
• is not clearly focused in one spot
  
• may radiate to shoulder, arm, jaw, neck, back, or other areas