Angina Pectoris: Causes, Symptoms, Diagnosis and Treatment


It is called angina pectoris to chest pain and a sensation of acute and suffocating oppression, usually retrosternal, that is, centered behind the sternum, and sometimes extended (irradiated) to either arm. Chest pain usually lasts from one to two minutes, for as long as 10 to 15 minutes. Sometimes there is a feeling of heaviness or tightness in the chest that does not reach pain.

Signs and symptoms of Angina Pectoris

The attacks are usually triggered by exercise (lifting weights, sport, sexual activity) or emotional stress, and are relieved by rest. They can also be triggered by extreme cold or by heavy meals.

Feeling of anxiety or imminent death.

Angina is a symptom, not a disease. It is the direct result of lack of blood in the heart muscle (ischemia). When one strives, the heart needs more oxygen to work harder. When the coronary arteries are affected and cannot adjust to the increased demand for blood, the nerves of the heart transmit painful messages of urgent warning to the brain. Referred or irradiated pain is because the brain, from confusion, feels the impulses from nearby locations such as the arms, neck or jaw.

angina pectoris

Angina is common. In men it usually occurs after 30 years of age, and in women later. The cause, in most cases, is atherosclerosis.

Stable angina is the one that always occurs with the same level of exercise, and the duration of the attacks is similar.When attacks become more frequent and long or are not linked to physical activity, cardiologist’s talk of unstable angina, which may be the warning of an imminent heart attack and needs special treatment.


There are no laboratory tests for the diagnosis of angina. However, it may be useful to have some tests to rule out any damage to the heart, as well as to detect the presence of conditions such as hyperthyroidism or anemia, which can force the heart to beat faster, use more oxygen, and therefore both precipitate angina.

The ECG only detects alterations at the precise moment of pain. Subsequently, it can only confirm or rule out in some cases that there has been damage to the heart.

Read More About: Anemia

Therefore, the diagnosis of angina is clinical, that is, it does not need to be confirmed if the symptoms and the overall clinical history are suggestive.


The treatment of angina is that of coronary heart disease, and is aimed at decreasing the burden of the heart and its oxygen needs:

  • Stop smoking.
  • Lose the extra pounds.
  • Exercise. Having angina does not mean that one has to become a sedentary being. In fact, exercise is a key part of managing coronary heart disease. It must, of course, be compatible with the limitations imposed by pain and its general condition (see the guide on “Cardiovascular Health”).
  • Medication.
  • Nitroglycerin (Vernies, Cafinitrine, etc.) dilates the coronary arteries and usually reverses the pain in minutes. It is taken under tablets under the tongue or also in spray. It can give headache as a side effect.
  • Calcium-antagonists or calcium channel blockers prevent the entry of calcium into myocardial cells. This decreases the tendency of the coronary arteries to narrow and also decreases the work of the heart and therefore their oxygen needs. They also lower blood pressure.
  • Beta-blockers. They act by blocking many effects of adrenaline in the body, particularly the stimulating effect on the heart. The result is that the heart beats slower and with less force, and therefore needs less oxygen. They also lower blood pressure.
  • Surgery. In the case of unstable angina or that resists drug treatment, surgery may be able to correct the obstruction of the coronary vessels, either by bypass or in some cases by opening the narrowed vessels or coronary angioplasty.

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