Angina

Angina
Other names	Stenocardia, angina pectoris
Illustration depicting angina
Pronunciation	⫽ænˈdʒaɪnə, ˈændʒɪnə⫽ ann-JY-nə, AN-jin-ə[1]
Specialty	Cardiology
Complications	Heart attack, unstable angina

Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium).^[2] It is most commonly a symptom of coronary artery disease.^[2]

Angina is typically the result of partial obstruction or spasm of the arteries that supply blood to the heart muscle.^[3] The main mechanism of coronary artery obstruction is atherosclerosis as part of coronary artery disease. Other causes of angina include abnormal heart rhythms, heart failure and, less commonly, anemia.^[4] The term derives from the Latin angere ("to strangle") and pectus ("chest"), and can therefore be translated as "a strangling feeling in the chest".

There is a relationship between severity of angina and degree of oxygen deprivation in the heart muscle. However, the severity of angina does not always match the degree of oxygen deprivation to the heart or the risk of a heart attack (myocardial infarction). Some people may experience severe pain even though there is little risk of a heart attack whilst others may have a heart attack and experience little or no pain.^[5][6] In some cases, angina can be quite severe. Worsening angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina (usually grouped with similar conditions as the acute coronary syndrome). As these may precede a heart attack, they require urgent medical attention and are, in general, treated similarly to heart attacks.^[7]

In the early 20th century, severe angina was seen as a sign of impending death.^[8] However, modern medical therapies have improved the outlook substantially. Middle-age patients who experience moderate to severe angina (grading by classes II, III, and IV) have a five-year survival rate of approximately 92%.^[9]