What is angina pectoris?

Patients suffering from angina often report a choking, squeezing or burning sensation in the chest. An episode of angina is not a heart attack (myocardial infarction).

Unlike a heart attack, the heart muscle is not permanently damaged and the pain usually goes away with rest.

Coronary artery disease (CAD) and its complications, angina pectoris and myocardial infarction, are the leading cause of death in Europe and the United States.

The most common cause of CAD is a disease called arteriosclerosis, which causes thickening of the inner wall of the arteries that supply the heart. This wall involvement, called atherosclerotic plaque, is composed of cholesterol, fatty compounds, calcium and a clotting substance called fibrin.

The pain usually occurs when the heart needs more blood supply, such as during exercise or emotional stress. Angina usually starts in the centre of the chest but may spread down the arm, into the neck or to the jaw. Some people report numbness or a loss of sensation in the arms, shoulders or wrists.

An episode lasts only a few minutes and disappears with rest. Some patients with coronary artery disease may not experience angina pectoris. A deficient supply of oxygen to the heart (ischaemia) does not cause pain. This is called "silent ischaemia".

Other causes of angina include narrowing of the aortic valve (aortic stenosis), anaemia and an overactive thyroid gland (hyperthyroidism).