Angina pectoris is a discomfort in the chest, neck, back, or arms caused by an inadequate supply of oxygen to the heart muscle. Angina occurs most commonly in people with coronary atherosclerosis, a condition in which blockages develop in the arteries that supply the heart muscle with blood. Other causes of angina include:
- High blood pressure
- Valvular heart disease
Many people describe the discomfort of angina as a "burning" or "fullness" in the center of the chest. Other characterizations include "squeezing," "pressure," "strangling," or "choking." The discomfort will often radiate to the neck or arms, and may be associated with difficulty breathing, sweating or nausea.
Angina is typically produced by any activity that increases the heart's need for oxygen. Physical activity, such as walking, climbing stairs, or cleaning house, may provoke angina. Also, strong emotions, eating a large meal, or dramatic changes in weather may produce angina. Angina is usually more easily provoked in the morning, and may be more difficult to provoke as the day wears on.
The evaluation of people with suspected angina pectoris should include a detailed medical history and physical examination, routine blood testing with particular attention to cholesterol levels, and an electrocardiogram. An exercise stress test should also be performed. In many cases, sophisticated types of exercise testing, such as nuclear perfusion imaging or stress echocardiography, are needed.
Angina pectoris is usually treated with medication that is given once or several times per day. In some cases, angina that is difficult to control may require more aggressive treatment, such as coronary angioplasty or coronary artery bypass surgery.