Angina (pronounced an-ji-na) or angina pectoris is produced when the supply
of oxygen that is carried by blood is unable to meet the demands of the heart
muscle. The decreased supply of blood is created by an obstruction within the
coronary artery which impedes blood flow across it. Atherosclerosis is the
commonest cause of obstruction. However, obstruction may also result from
coronary artery spasm or the use of "crack" cocaine. Angina pectoris is a
recurring symptom and usually occurs in the form of chest discomfort (tightness,
fullness, squeezing, heaviness, burning or pain) in the center of the chest and
/or over the left breast). The discomfort may move to the left shoulder and arm
(although it may move to both shoulders/arms, throat, jaw, or even the lower
portion of the chest or upper abdomen). It may be accompanied by shortness of
breath, sweating, weakness, dizziness or nausea, or numbness in the shoulders,
arms and hands. When the build up of plaque is gradual, the patient's symptoms
are relatively predictable and stable. Such patient's usually have symptoms that
are provoked by specific levels of exercise. They are generally brief, last only
2-3 minutes, and subside promptly with cessation of exercise or following the
use of a nitroglycerin tablet. This pattern of pain is known as stable angina.
The partial and temporary decrease in oxygen supply to the heart muscle does not
generally cause permanent damage (unlike a heart attack).
Some patients may have atypical (not typical) symptoms. For example, the pain
may be confined to left shoulder, throat, jaw, or between the shoulder blades.
Others may have shortness of breath or sudden weakness, while approximately 10%
may have no symptoms, even when the heart is severely stressed or undergoing a
heart attack. Such patients are said to have a defective warning system.
Diabetic patients are more prone to have atypical or no symptoms.
Because there are several causes of chest pain that are unrelated to the
heart, many patients tend to ignore their symptoms attributing it to heartburn,
mitral valve prolapse, a gall bladder attack, muscle sprain, etc. If you have
risk factors for coronary artery disease and are having unusual symptoms
suggestive of angina or a heart attack, make sure that you consult your doctor
about your complaints.