Angina Pectoris

What is Angina Pectoris?

Angina pectoris is the medical term for chest pain, and is usually the primary symptom of myocardial ischemia, a condition where the heart does not get as much blood as it needs, as well as other heart disease.

Symptoms of Angina Pectoris

Angina feels like uncomfortable pressure, squeezing, or pain in the chest area. It can occur when the body is under exertion, as in stable angina, or when the body is at rest, as in the case of unstable angina.

Although angina pectoris is not a heart attack, it is a sign that someone is at an increased risk of having a heart attack, and should receive medical attention.

Risk Factors of Angina Pectoris

The risk factors for experiencing angina are similar to risk factors for developing coronary artery disease, and include:

  • High blood pressure
  • Cigarette smoking
  • High cholesterol
  • Overweight/obesity

Types of Angina Pectoris

There are four main types of angina pectoris:

  • Stable angina – Chest pain is usually predictable and is brought on when the person is under physical exertion or emotional or mental stress. Pain can be relieved with rest or medication (nitroglycerin).
  • Unstable angina – Chest pain is unexpected, more severe and often occurs while the person is at rest. Should be treated as an emergency.
  • Variant angina pectoris (Prinzmetal’s angina) – Similar to unstable angina, but nearly always occurs while a person is at rest. Occurs as the result of a coronary artery spasm, a rare condition.
  • Microvascular angina – Chest pain occurs, but no sign of coronary blockages exist. Pain usually caused by poor circulation in the tiny blood vessels that nourish the heart. Can be treated similarly to stable angina.

Causes of Angina Pectoris

Angina is typically caused by the heart not receiving enough blood as the result of coronary artery disease.

Diagnosing Angina Pectoris

If you experience chest pain, you need to be examined by your doctor to find the cause of the chest pain and to be properly treated. Although simply experiencing chest pain is not an actual heart attack, it can indicate that you are at a higher risk of experiencing a heart attack.

To find the cause of your chest pain, your doctor will review your symptoms, your medical and family medical history, and perform a physical exam. He/she may also recommend additional tests, such as:

  • Electrocardiogram (EKG) – measures rate and regularity of heart beat
  • Stress EKG or Stress Test –EKG performed while patient is performing moderate exercise, such as jogging or riding a stationary bike
  • Angiography – minor catheter-type procedure that allows doctor to examine the inside of the arteries for damage or blockage.

Treatment Options

The best way to treat and prevent angina is to treat the underlying coronary artery disease. This can be done through lifestyle changes, medication, or, sometimes, surgery.


The following is highly recommended in treating as well as preventing coronary artery disease:

  • Eat healthy – Stick to a heart-healthy low fat, low sodium, low cholesterol diet.
  • Quit smoking – Stop smoking or using any smokeless tobacco products.
  • Exercise – Moderate, daily exercise provides great benefit, but do not overexert.
  • Lose weight – If you are considered overweight or obese, talk with your doctor about the best way for you to shed the extra weight.


The following are the most common medications prescribed to treat angina:

  • Nitroglycerin – widens blood vessels, allowing more blood to flow to the heart muscle and decreases the workload on the heart
  • Beta blockers – slows heart rate and decrease the force of the heart muscle
  • Calcium channel blockers – reduces frequency and severity of chest pain


Surgery may be recommended if lifestyle changes and medication alone do not relieve the angina or if the risk for heart attack increases. Possible surgical procedures include:

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