Heart
Angina Pectoris
Chest pain or discomfort caused when your heart muscle doesn't get enough oxygen-rich blood.
Angina pectoris is chest tightness or pressure triggered by the heart not receiving enough oxygen-rich blood. It is not itself a disease but a critical warning sign of underlying coronary artery disease that requires specialist evaluation.
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Angina is often felt as a squeezing pressure in the chest, acting as a critical warning sign of underlying heart disease.
Symptoms
- Pressure, tightness, or heaviness in the chest
- Pain radiating to the jaw, neck, shoulders, or arms
- Triggered by physical exertion or emotional stress
- Atypical presentations in women: fatigue, shortness of breath, nausea
Types of Angina
- Stable angina — predictable, exertion-triggered, relieved by rest
- Unstable angina — occurs at rest, lasts longer, medical emergency
- Variant (Prinzmetal's) angina — caused by coronary spasm, occurs at rest or during sleep
- Microvascular angina — small vessel dysfunction, more common in women
Diagnosis
- Clinical history and resting ECG
- Stress testing to evaluate cardiac response to exertion
- Cardiac CT coronary angiography
- Invasive coronary angiography for definitive assessment
Treatment Options
- Medications: nitrates, beta-blockers, calcium channel blockers, statins
- Coronary angioplasty and stenting
- Coronary artery bypass surgery
- Enhanced External Counterpulsation for refractory cases
Emergency Warning Signs
Seek immediate emergency care for chest pain at rest, pain unrelieved by nitrates, breathlessness, sweating, or radiation to the jaw or arm.
Concerned About Angina Pectoris?
Dr. Peter Chang offers specialist assessment and personalised management at Paragon Medical Centre, Singapore.