Angina Pectoris

Definition: What Is Angina Pectoris?

Angina pectoris literally means "chest tightness" another synonymously related term is stenocardia. This is a sudden onset of pain in the heart region that is accompanied by a feeling of pressure in the chest and is usually dull or constricting.

Angina Pectoris Stages

Stable angina pectoris, unstable angina pectoris, and microvascular angina pectoris can be distinguished.

Stable angina pectoris is when the same pain occurs repeatedly but resolves within minutes with medication or rest. It is divided into 5 stages from 0 to 4. Stage 0 means "no symptoms," and stage 4 implies "discomfort with the slightest physical exertion."

Unstable angina pectoris occurs when the intensity or duration has increased compared to previous attacks. For example, a first attack and an attack occurring at rest are unstable angina pectoris. This is associated with an increased risk of a heart attack.

Microvascular angina pectoris is a localized circulatory disorder with a good prognosis.

Angina Pectoris Causes

The cause of an angina pectoris attack is usually an undersupply of blood in the heart muscle and a corresponding lack of oxygen in the muscles. Such an undersupply is typically a disease of the coronary arteries (CAD). In this case, arteriosclerotic deposits occur, which leads to a narrowing of these coronary vessels.

High blood pressure, obesity, lack of exercise, and diabetes are not negligible risk factors for angina pectoris.

Angina Pectoris Diagnosis

The diagnosis of angina pectoris is made in several steps. First, the treating physician takes a medical history, in which he addresses the causes and symptoms of the attack. This is followed by a physical examination, during which the heart is auscultated, and a blood pressure measurement.

To determine the function and blood supply of the heart muscle, various imaging procedures are helpful. These include, for example:

• Echocardiography
• Resting, long-term, and stress ECG
• Stress MRI
• Cardiac scintigraphy

Angina Pectoris Therapy

The primary goal of therapy is to prevent severe angina pectoris attacks and myocardial infarction. Unstable angina pectoris should be treated urgently by a summoned emergency physician! Acute attacks are usually treated with nitro preparations.

Surgical intervention may be necessary, e.g., balloon dilatation or bypass surgery. In addition, other permanent medications, e.g., blood thinners or beta-blockers, may be indicated.

The first important step in angina pectoris therapy is to reduce existing risk factors. These include regular physical activity, a healthy diet, possible weight reduction, and abstaining from nicotine. High blood pressure should also be treated.

What Is the Prognosis for Angina Pectoris?

Depending on the stage, the course of this disease can at least be influenced positively. The measures mentioned above can reduce the risk of a more severe course of the disease.

Sources:

Stierle, U.: Klinikleitfaden Kardiologie. München: Urban & Fischer Verlag/Elsevier Gmbh, 2017

Erdmann, E.: Klinische Kardiologie: Krankheiten des Herzens, des Kreislaufs und der herznahen Gefäße. Heidelberg: Springer, 2008