Angina

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In medicine, angina is the "symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed that supplied by the coronary circulation."[1]

Angina may be a symptom of coronary heart disease.

Angina has three characteristics:[2]

  1. "Substernal chest discomfort with a characteristic quality and duration that is"
  2. "provoked by exertion or emotional stress"
  3. "relieved by rest or nitroglycerin"

Based on the number of these characteristics that a patient's chest pain has, the angina is further categorized as:[2]

  • Typical angina has all three characteristics
  • Atypical angina has two of the three
  • Nonangina chest pain has only one of the three

Angina that occurs at rest, originally described by Prinzmetal, is now considered a variant form. [3] Subsequently, the term Prinzmetal angina is now regarded as a subset of coronary artery vasospasm[4]

The probability of underlying coronary heart disease can then be estimated (see table).[5][6][7]

References

  1. Anonymous (2015), Angina (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. 2.0 2.1 Gibbons RJ, Chatterjee K, Daley J, et al (June 1999). "ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina)". J. Am. Coll. Cardiol. 33 (7): 2092–197. PMID 10362225[e]
  3. {{MeSH|Angina Pectoris, Variant]]
  4. Andrew P Selwyn and James L Orford (Nov 8, 2005), "Coronary Artery Vasospasm", eMedicine
  5. Gibbons et al (2002). Stable Angina Guideline Update - Figures and Tables. American College of Cardiology/American Heart Association.
  6. Diamond GA, Forrester JS (June 1979). "Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease". N. Engl. J. Med. 300 (24): 1350–8. PMID 440357[e]
  7. Weiner DA, Ryan TJ, McCabe CH, et al (August 1979). "Exercise stress testing. Correlations among history of angina, ST-segment response and prevalence of coronary-artery disease in the Coronary Artery Surgery Study (CASS)". N. Engl. J. Med. 301 (5): 230–5. PMID 449990[e]