Angina pectoris


Angina pectoris is an undersupply of oxygen to the heart, which is accompanied by seizure-like pain. Angina pectoris is divided into stable, unstable and prinzmetal angina. All of them are based on a deficient supply of oxygen to the heart.

Prinzmetal’s angina differs from the other two in the cause of the lack of oxygen. With around 300,000 hospital admissions per year, angina pectoris is one of the most common causes of hospital admissions. The most common symptoms are listed and explained below.

  • Chest pain/pain behind the sternum
  • Breast tightness/pressure on the chest
  • Shortness of breath
  • Fear/Panic
  • Back Pain
  • Neck-/neck pain
  • Upper abdominal pain, nausea/vomiting
  • Pain in left arm/left shoulder
  • Jaw/toothache

The typical symptom of angina pectoris is sudden onset of chest pain behind the sternum, which most patients experience as dull, pressing or even constricting. Chest pain is the leading symptom of heart disease. Angina pectoris itself refers to the chest tightness and chest pain caused by coronary heart disease (CHD).

CHD leads to a lack of supply to the heart muscles and thus causes pain. Most often, the pain is felt in the chest area, often directly behind the breastbone. The chest is also affected by a feeling of pressure or tightness.

Those affected describe the feeling as if someone had placed a heavy bag on their chest. The chest pain and tightness typically occur in attacks of angina pectoris and last for about one to five minutes. Such an angina pectoris attack is often triggered by stress or physical strain.

It can usually be relieved well with nitro spray. Only rarely do the patients merely feel a feeling of pressure or anxiety, tightness or a burning sensation in the chest. In many cases, the pain radiates into the left arm; radiating into the right arm or both arms is less frequent but possible.

Angina pectoris can also radiate into the neck, lower jaw, back or upper abdomen. The symptoms of angina pectoris are very similar to those of a heart attack and should be taken seriously as a warning symptom. Chest pain can be accompanied by shortness of breath, weakness and dizziness.

Affected persons very often have feelings of anxiety up to fear of death. Angina pectoris is often triggered by physical exertion such as climbing stairs or walking fast. Emotional stress such as stress or arguments can also cause angina pectoris.

A cold outside temperature and an extensive meal shortly before the onset of symptoms can increase the pain, but also trigger it. Angina pectoris usually lasts five to fifteen minutes and improves with rest or the administration of nitro spray, which contains the active ingredient nitroglycerin and increases the blood flow to the heart muscle, thus relieving the symptoms. In patients with diabetes mellitus, angina pectoris can also go completely unnoticed because diabetics perceive pain differently than patients without diabetes due to the nerve damage caused by diabetes (diabetic neuropathy).

Such an angina pectoris is called “silent angina pectoris”. Besides chest pain, back pain is also one of the symptoms of angina pectoris. Many sufferers describe pain that runs in a belt-like manner around the chest.

Both chest and back are equally affected by pain. Pain that occurs in attacks in particular indicates angina pectoris. The pain is usually perceived as dull, stabbing or drilling.

Since the heart is affected by angina pectoris, back pain is usually perceived at the level of the thoracic spine. Women, elderly people over 75 years of age and patients who have undergone heart surgery also perceive pain differently, so that in these groups of people non-specific symptoms can be observed, including nausea, dizziness, shortness of breath or radiation to the upper abdomen. Chest pain can be completely absent. Angina pectoris is described as stable if the symptoms remain the same over a longer period of time in several episodes. Unstable angina pectoris refers to the first occurrence of angina pectoris or a stronger attack of angina pectoris compared to the previous attack.