Understanding Angina: Angina Pectoris

This is part six in our series entitled the Heart of the Matter. Part five can be found here. Do note the disclaimer.

This medical term simply means chest pain on effort, relieved by rest. It is probably the hallmark of CAD. Different patients may describe them differently but the underlying characteristics remain the same. The pains, or sometimes discomfort, occurs when one is walking fast, bathing, having sex, washing the car, playing golf or climbing the stairs or hill. When the patient slows down or ceases the activity, the chest pain or discomfort, soon ceases.

A typical story told to me would go something like this, "Doc, over the last two months, I noticed that whenever I climb the hill outside my house, I would experience this tightness over the front of my chest, that cause me to stop for a few minutes. With the rest, it would soon disappear and I can continue to walk again".

This discomfort, sometimes spreads to the jaw, and the left arm (inner aspect). Although the location of the pain is important (the front of the chest, below the breast bone, around the whole chest, around the lower jaw, between the two shoulder blades at the back, and sometimes over the epigastrium).

Just to reiterate, the most important character of angina pectoris, is chest pains on effort, which is relieved by rest. It is worthwhile to note that the amount of activity required to bring on the pains, is inversely proportional to the degree of the heart artery narrowing. Chest pains brought on by severe activity, must reflect lesser degrees of narrowing, then chest pains brought on by minimal activity.

In our next part we will be covering unstable angina.