Angina Pectoris - chest discomfort originating from the HEART, usually resulting from restricted BLOOD flow due to CORONARY
ARTERY DISEASE (CAD) that occludes (blocks) one or more of the CORONARY ARTERIES.
Coronary ARTERY spasm, especially that resulting from COCAINE use, may also cause angina. Some people experience a crushing pressure that radiates into the left shoulder, arm, and THROAT. Other people experience discomfort similar to DYSPEPSIA (indigestion or heartburn). Though the nature and quality of discomfort varies among individuals, for most people angina pectoris is a chronic (long-standing) condition with predictable symptoms that appear with exertion and subside with rest.
Treatment for angina pectoris generally combines relieving symptoms and mitigating the underlying cause. Medications to treat angina pectoris cause smooth muscle tissue (such as makes up the walls of the arteries) to relax. This allows the coronary arteries to modestly increase the flow of blood, which usually is sufficient to ease symptoms.
Commonly prescribed medications include nitrates such as nitroglycerin and isosorbide, beta antagonist (blocker) medications such as atenolol and propanolol, and calcium channel antagonist (blocker) medications such as diltiazem and verapamil.
Cardiologists typically recommend ASPIRIN THERAPY for people who have angina pectoris, to help prevent MYOCARDIAL INFARCTION (blood clot that blocks the flow of blood, causing heart tissue to die).
For some people, the most effective treatment is ANGIOPLASTY to repair, or CORONARY ARTERY BYPASS GRAFT (CABG) to replace, occluded coronary arteries. However, many people who have angina pectoris remain stable with medication therapy.
Cardiologists disagree about the value of CABG for people whose only symptom of disease is angina pectoris, because there is growing evidence that the risks of the surgery (including rapid occlusion of the grafts) do not counterbalance the benefits.