Chest pain or angina pectoris: symptoms, treatment

Angina pectoris involves chest pain originating from the heart. It usually occurs with exertion and disappears quickly when a person rests. You are more likely to develop angina pectoris with increasing age. It occurs more often in men up to the age of sixty, after which the risk is the same for men and women. There are a number of risk factors such as smoking and fatty foods. What are the causes and symptoms (complaints) of angina pectoris? How is it diagnosed, how can it be treated and what is the prognosis?

Article content

  • Angina pectoris
  • Women under the age of sixty often suffer less from angina pectoris
  • Causes of angina pectoris
  • Symptoms of angina pectoris
  • Complications angina pectoris
  • Diagnosis of angina pectoris
  • Treatment of angina pectoris
  • Prognosis
  • Isordil, Nitrospray (note!)

Angina pectoris

Angina pectoris is chest pain that occurs when the heart muscle has to work harder , for example when a person exerts himself, when transitioning from heat to cold, or during intense emotions. The pain diminishes quickly at rest. The pain you feel is due to insufficient blood supply to the heart. Over the last thirty years, the number of cases of angina pectoris has decreased in the Western world. This is because people have started to live healthier, new medication plays a role and surgical techniques have improved.

Women under the age of sixty often suffer less from angina pectoris

Both men and women can get angina pectoris, but women under the age of sixty are less likely to experience it because the hormone estrogen protects them. The protective effect slowly diminishes after menopause.

Causes of angina pectoris

  • Coronary artery disease is the most common cause of angina pectoris. A narrowing of the coronary arteries that supply oxygen to the heart muscles. This narrowing is usually caused by fatty deposits on the inside of the walls of the arteries. Blood flow may be sufficient for the heart when the body is at rest, but not sufficient during exercise. If not enough oxygen-rich blood flows through the heart, the heart muscle does not receive enough oxygen. Toxins accumulate in the heart muscle and cause pain. This pain can be described as: contracting, cramping.
  • Angina pectoris can also be caused by involuntary contractions of the coronary arteries. These then become narrower for a short time.
  • People with high levels of cholesterol in the blood, hypertension or diabetes mellitus are more likely to develop arteriosclerosis and angina pectoris.
  • Anemia can be the cause of angina pectoris, as the blood cannot absorb enough oxygen. But this is rarely the cause.
  • It can also be due to a malfunctioning heart valve that hinders blood flow to the heart.

Symptoms of angina pectoris

  • The pain can vary from mild to severe.
  • The pain usually appears with exertion and disappears after resting for a while.
  • The unpleasant feeling in the center of the chest is experienced as oppressive, oppressive, heavy.
  • The pain may radiate to the throat or arms, especially the left arm.
  • Angina pectoris often occurs more quickly outdoors when the weather is cold or when there is a lot of wind.

Complications angina pectoris

It is important to consult your doctor if you experience the pain for the first time. Also sound the alarm immediately if the complaints become more common. If the symptoms worsen, this may indicate a blood clot in the coronary artery and complete blockage. There is a chance of having a heart attack. If an attack of angina pectoris is prolonged and severe, this may indicate a myocardial infarction .

Diagnosis of angina pectoris

  • A doctor can make the diagnosis based on the complaints. But sometimes it can be difficult to be sure that angina is causing the pain. For example, it could also be something completely different, such as reflux to the esophagus.
  • Blood pressure will be measured to see if there is high blood pressure.
  • The blood will be tested for anemia or high cholesterol.
  • ECG: The electrical activity of the heart is monitored. The ECG at rest may be normal, but the exercise ECG will probably be abnormal if you have angina pectoris. An ECG can also show that someone has had a heart attack.
  • If tests show that the blood supply to the heart is not good, a coronary angiogram (contrast fluid in coronary arteries) may be performed.

Treatment of angina pectoris

Treatment depends on how serious the situation is.

  • Sudden attacks of pain can be counteracted by medication and the frequency and severity of the attacks can also be reduced. An acute attack is often treated with nitrates. Nitrates relieve pressure on the heart by widening the vessels and widening the coronary arteries. Fast-acting nitrates can be prescribed as a spray or soluble tablets under the tongue. Slow-acting nitrates are used over a longer period of time to prevent attacks.
  • There are also medications that reduce the heart’s need for oxygen (beta blockers).
  • A doctor may also recommend a low daily dose of salicylic acid. Salicylic acid inhibits platelets, reducing the risk of blood clots forming in the arteries.
  • It may be necessary to adjust your lifestyle: quit smoking (smoking less is not enough), consume a diet low in saturated fats, lose weight if necessary.
  • A doctor will probably prescribe medication to reduce the level of cholesterol in the blood. To slow the progression of coronary heart disease.
  • Exercise regularly, as much as you can handle, but stick to the limits specified by the doctor!
  • If the angina pectoris worsens despite medication, a doctor may decide that surgical intervention is necessary to widen the arteries or to promote the flow of blood to the heart.
  • Angioplasty can also be an option. A balloon is placed in the part that is narrowed and inflated to widen the arteries. You can usually go home the same day or the day after this procedure.
  • If multiple coronary arteries are narrowed, angioplasty is initially performed. But if this does not have the desired result, you can opt for coronary artery bypass surgery . It is a serious operation, you will be in intensive care after the operation. The hospital stay usually lasts a week. The entire recovery takes a while, think two to three months.


The outlook depends on the stage of coronary artery disease. If it is mild angina pectoris, the prospects are good. Then you have to make the changes in the way of life that are necessary and it is important to follow the doctor’s recommendations. Most people have no symptoms after treatment starts. There may be limitations in exertion. If the arteries are severely damaged, the prospects are less good.

Isordil, Nitrospray (note!)

Follow the instructions of your doctor or pharmacist. It is important that you sit or lie down quietly when you take the medication. Wait a while and definitely don’t start walking around right away, as you may feel very bad. Due to the vasodilatory effect of these medications, headaches, palpitations or dizziness may occur.