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Angina pectoris is a term for chest pain or discomfort caused by the heart muscle not getting enough oxygen. This lack of oxygen is also called myocardial ischaemia. This may occur due to a decreased supply of oxygen to the heart (due to narrowing of the coronary arteries supplying the heart muscle) or increased demand on the heart muscle such as during exercise (even just walking), stress or fast heart rate. The symptoms may disappear when, for example, exercise is stopped. An attack of angina means that you are at increased risk of a heart attack (acute myocardial infarction or AMI) and should see a doctor right away.

There are three main types of angina:

  1. Stable angina is characterised by predictable periods of discomfort that occur during exercise or periods of stress. This pain may be relieved with rest and/or glyceryl trinitrate (GTN)
  2. Unstable angina is characterised by sudden and unexpected onset of pain, usually during periods of rest. The pain may be more severe than with typical angina. People with unstable angina are at increased risk for myocardial infarction (MI), severe cardiac arrhythmia, and cardiac arrest. This is an acute emergency and should be treated immediately.
  3. Variant angina (Prinzmetal’s angina) almost always occurs during periods of rest – usually at night. The cause is a spasm of a coronary artery.

A doctor can identify which type of angina a patient may have based on information obtained from your medical history, and a range of investigations such as electrocardiograms (ECG) and exercise tolerance ("stress") testing (ETT).

Treatment may include the use of a variety of medications to reduce the frequency and severity of attacks, e.g. beta blockers, nitrates and anticoagulants such as aspirin. Surgical procedures, such as angioplasty or coronary artery bypass grafting (CABG) may be required in some cases.

Last Review Date: March 6, 2017

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