Angina Pectoris (Stable Angina); Causes, Symptoms and Treatment

Angina pectoris is a medical condition in which there is chest pain or discomfort that occurs due to a disease or pathology of the coronary arteries (arteries supplying the heart’s muscle, called coronaries because they resemble a “crown” over the heart). It is a mismatch problem between the heart’s demands and supply of oxygen. Stable angina is the most common type of angina.

Causes of angina pectoris

Stable angina is a gradual process featuring the narrowing of the coronary arteries through the deposition of fatty plaques in the walls of the arteries, better known as atherosclerosis. It takes years to show its effects and rarely occurs before the 40s -although the rising trends of sedentary lifestyles and unhealthy diets have reduced that age considerably-. Such narrowing of the coronaries causes a decrease in the flow of blood that reaches the heart’s muscle and, since the heart is sensitive to drops of oxygen supply, impairs its function.

The causes of such fat deposition are various and are better termed “risk factors”; they include the following:

    • Tobacco smoking has a detrimental effect on the health of your heart and blood vessels in general. It also “injures” the blood vessels and eases the process of fat deposition. Smoking also causes hypertension.
    • Males are more liable to develop coronary artery disease than females and develop this condition at an earlier age owing to the effect of their sex hormones (testosterone), and how they increase the level of bad cholesterol (LDL). On the other hand, females have estrogen, which helps them increase the level of good cholesterol (HDL), thereby keeping the health of their blood vessels roughly until menopause.
    • An unhealthy diet especially that rich in refined sugars and saturated fats. Most of the cholesterol in our body is made in the liver from non-fat sources, most importantly, carbohydrates.
    • A sedentary lifestyle and lack of physical exercise, because exercise helps burn calories and increase the blood supply to the heart in the long term. It also guards against hypertension.
    • Hypertension accelerates the condition as it injures the blood vessels.
    • Diabetes is also a significant contributing factor. In diabetes, the body can’t use glucose appropriately due to insulin deficiency and/or resistance. Therefore it uses fats which increases the level of mobilised cholesterol in the body.
    • Obesity causes elevated levels of blood cholesterol and increases insulin resistance, predisposing to type 2 diabetes and related cardiovascular problems.

Angina pectoris symptoms

Some of the symptoms in angina pectoris are quite characteristic, while the rest may be vague. The most prominent symptoms are:

1) Chest pain

Chest pain, Angina pectoris, Stable angina

Chest pain is the most critical symptom of angina, and although it is termed “pain”, the sensation is usually more like fullness, discomfort, squeezing or pressure sensation in the chest, usually just behind the breastbone. It may also be felt in the jaw, left shoulder, left arm or in the upper abdomen. It may feel like a burning sensation and is commonly confused with indigestion and heartburn. Anginal pain is characteristically aggravated by effort, emotional upset, anxiety, cold weather and heavy meals, and is relieved by rest and sublingual application of nitrates. Anginal pain is usually brief and lasts from 1 to 10 minutes. Due to the chronic nature of the disease, patients are generally able to predict their attacks according to the effort they exerted. This, however, doesn’t mean that the condition is stationary. Instead, it is slowly progressive and will invariably end in angina at rest if not controlled.