ANGINA PECTORIS

spasm of pain in the chest, usually brought on by exertion in persons who have diseased coronary arteries. A deep, viselike pain is felt beneath the breastbone and over the heart and stomach, and it sometimes radiates into the left shoulder and down the inner side of the left arm. A feeling of constriction or suffocation often accompanies the pain, though there is seldom actual difficulty in breathing. In acute cases, the sufferer becomes pale, his pulse is feeble, and he feels that death is imminent. Anginal pain may be quite mild in some cases, but its peculiar qualities can still induce feelings of anxiety in the sufferer. Attacks of angina can be precipitated by walking or more strenuous exertion, by a fit of anger, fear, or some other stressful emotional state, by exercising after a heavy meal, or simply from exposure to cold or wind. A person stricken with angina is obliged to stop whatever activity he is engaged in and rest, and after three or four minutes the pain subsides as quickly as it began. Angina is caused by the inability of diseased coronary arteries to deliver sufficient oxygen-laden blood to the heart muscle. The arteries have been narrowed by atherosclerosis (hardening of the arteries), and when insufficient blood reaches the heart, waste products accumulate in the heart muscle and irritate local nerve endings, causing anginal pain. Attacks of angina are apt to recur following less and less exertion as a person's coronary artery disease worsens. Angina pectoris is rare in persons under middle age and is much more common in males than in females. An anginal attack can be relieved by rest or by taking nitroglycerin or other drugs that relax (and thus dilate) the blood vessels. The frequency of attacks can be lessened by the avoidance of emotional stress and by shifting to exercise that is less vigorous. In cases where the narrowing of the coronary arteries appears serious enough to cause a heart attack (myocardial infarction), surgery must be used to widen the passages within the arteries or replace the arteries with unblocked ones from another portion of the body.