Angina Pectoris Symptoms

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Angina Pectoris Symptoms
Angina Pectoris Symptoms

Video: Angina Pectoris Symptoms

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Video: Angina pectoris (stable, unstable, prinzmetal, vasospastic) - symptoms & pathology 2023, January

Angina pectoris: causes & symptoms

Sharp chest pain is a typical symptom of angina pectoris. Coronary artery disease can, however, occur without any symptoms. The severity of the disease depends on which vessels are narrowed to which point and how much. The term angina pectoris means “chest tightness” translated from Latin…


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  • Risk factors for coronary artery disease
  • A healthy lifestyle prevents
  • Symptoms
  • Forms of angina pectoris

Risk factors for coronary artery disease

In most cases the cause of angina pectoris is coronary artery disease (CHD). This leads to changes in the coronary arteries. So-called arteriosclerosis, which manifests itself as hardening, thickening, loss of elasticity and narrowing of the arteries, is also known colloquially as hardening of the arteries. In these arteriosclerotic changes - also called plaques - fat deposits and connective tissue growths occur. As a result, the vessel diameter becomes smaller and smaller, and this can lead to massive vasoconstriction. The result is a poor oxygen supply to the heart muscle when the heart is working harder.

The following factors can increase your risk of coronary artery disease such as angina pectoris:

  • Hypercholesterolemia: Significantly increased risk with increased total and LDL cholesterol; an elevated HDL cholesterol, on the other hand, has a protective effect on the heart.
  • High blood pressure: The risk increases linearly with values ​​above 130/85 mmHg. More information under high blood pressure.
  • Diabetes mellitus: Due to the increased blood sugar level, the risk of vasoconstriction is four to six times higher than that of non-diabetics.
  • Genetic predisposition: There is an increased risk of cardiovascular diseases (eg heart attack, stroke or sudden cardiac death) of direct relatives with a positive family history.
  • Age and gender: The risk increases with age, for men from early adulthood, for women a little later - depending on the onset of menopause.
  • Increased tendency to form thrombi (eg hyperfibrinogenemia): Hyperfibrinogenemia can occur particularly in the context of other diseases, such as infections, tumors and being very overweight.
  • Smoking: 20 percent of all coronary heart diseases are associated with smoking. The risk increases with the number of cigarettes smoked daily and the number of years in which people have smoked.
  • Increased body weight and lack of exercise.

A healthy lifestyle prevents

Appropriate measures can positively influence all risk factors apart from genetic predisposition, age and gender. The aim of all preventive measures is to prevent or slow down the development of atherosclerosis. Above all, lowering high blood pressure and increased blood lipids as well as efficient blood sugar control are important. The following are particularly recommended:

  • Balanced diet: A “Mediterranean” diet with regular consumption of fruit, salad, vegetables, olive oil, fish and moderate wine consumption significantly reduces the risk of coronary heart disease.
  • Avoid or reduce obesity,
  • regular exercise,
  • no or little alcohol,
  • do not smoke.


Typical complaints are chest pain, which those affected often experience as dull, constricting or pressing, boring or burning and are sometimes associated with shortness of breath and fear. They are based on an insufficient supply of the heart muscle with oxygen-rich blood. The symptoms can also radiate to other parts of the body, for example to the shoulders, arms and hands (more left than right), sometimes also to the lower jaw region, the neck, back and upper abdomen. The symptoms usually occur during physical or psychological stress. For men, pain is usually the focus, women mainly suffer from symptoms such as nausea, dizziness, sweating and fear.

Forms of angina pectoris

A distinction is made between two main forms:

  • Stable angina pectoris (pre-infarct syndrome): The symptoms appear in the same way over a longer period of time with similar physical or psychological stress (stress). They last a few minutes and respond promptly to nitroglycerin (e.g. nitrospray). Other possible triggers are cold or large meals. According to the degree of severity, four stages are distinguished (as recommended by the Canadian Cardiovascular Society):

    • Stage I: No angina pectoris in everyday life.
    • Stage II: Angina pectoris with greater exertion (walking uphill, fast running in the cold, etc.) as well as with psychological stress.
    • Stage III: Angina pectoris during light physical exertion, for example when walking on the flat or doing everyday activities.
    • Stage IV: Resting discomfort or discomfort with minimal physical exertion.
  • Unstable angina pectoris: It can develop out of the stable form. The seizures either increase in intensity or duration with a simultaneous decrease in performance or an attack occurs suddenly despite previous well-being.

    The unstable angina pectoris is often based on a plaque rupture with subsequent thrombus formation. The transitions between unstable angina pectoris with no loss of myocardial cells and acute myocardial infarction (myocardial infarction) with death of myocardial cells - measurable on the basis of an increase in the so-called necrosis markers troponin I and troponin T or creatine phosphokinase (CPK) - are fluid and often not clearly distinguishable. Therefore, all phases of unstable angina pectoris up to myocardial infarction are summarized under the term of acute coronary syndrome. The distinction is made on the basis of the ECG changes and the presence or absence of necrosis markers in the blood. Since there are no differences in symptoms in heart attacks and unstable angina pectoris,these are also summarized as acute coronary syndrome until the final diagnosis is made.

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