Definition
Angina pectoris (literally “chest tightness”) usually describes attacks of pain in the chest area. The cause is a reduced blood supply to the coronary arteries. In coronary heart disease, for example, these are blocked or constricted by plaques and therefore cannot be supplied with blood properly. This results in a deficient supply of blood to the area of the heart muscle behind it. This so-called ischemia (undersupply of oxygen and other nutrients) can cause pain.
Causes
Angina pectoris attacks often indicate coronary heart disease. However, it can also have other causes, such as spasms (sudden short contractions) of the coronary arteries. Angina pectoris is often triggered by exposure to cold, stress or physical exertion.
In such situations, the body’s oxygen requirement increases. Therefore more blood has to be pumped from the heart into the circulation than is the case at rest. This extra work of the heart also requires a stronger blood supply to the heart muscles.
If this is not ensured, for example due to coronary heart disease, the above-mentioned undersupply of blood to the heart muscles occurs, which can lead to angina pectoris attacks. Such attacks usually last between one and five minutes. The symptoms can be quickly alleviated by the administration of nitroglycerine (often as a “nitro spray”).
Angina pectoris can be divided into different stages. People suffering from unstable angina have a significantly increased risk of having a heart attack. In stable angina pectoris, on the other hand, the symptoms stagnate, which means that the symptoms do not worsen.
Although this indicates a stenosis (narrowing) of the coronary vessels, it also means that the narrowing does not continue to expand. – In stage 0, there are no symptoms despite the occurrence of ischaemia. – Stage I is characterised by chest pain under heavy physical strain.
- If a slight angina pectoris occurs during normal physical exertion, this is referred to as stage II. – In contrast, stage III is characterised by considerable chest pain during comparable physical exertion. – One speaks of stage IV when angina pectoris symptoms already occur at low exertion or complete rest. In such cases it is usually unstable angina pectoris, in which the underlying disease (usually coronary heart disease) is progressive.
Forerunners
The pain in the jaw area can also occur weeks to months before the actual form of angina pectoris. However, these symptoms are very unspecific and should be well observed. The pain in the jaw does not have to be permanent, but can also occur intermittently.
Other harbingers such as a general feeling of weakness and exhaustion may also occur. These symptoms are often perceived as a kind of flu-like infection. Before pronounced angina pectoris develops, pain in the left arm is very common, especially in men.
Especially people who know of a family history of this symptom should consult a doctor when it occurs. Since the precursors are even more unspecific in women, early detection is correspondingly more difficult. At present, men are affected more frequently than women.
One of the reasons for this is that smoking is a risk factor for calcification of the coronary arteries and a heart attack. Since men used to smoke more than women, angina pectoris occurs more frequently in men than in women. However, since nowadays just as many women smoke as men, an equalisation can soon be expected.
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