What is Chronic Angina?

Chronic angina is a condition in which chest discomfort regularly manifests when the body is placed under emotional or physical stress. Often triggered by the presence of a secondary condition that compromises proper arterial function, such as atherosclerosis, chronic angina is caused by an inadequate supply of oxygenated blood to the heart muscle. Treatment for chronic angina may be multi-faceted in its approach, necessitating the use of medications and implementation of lifestyle changes. When arterial function is severely compromised, surgery may be performed to restore proper blood flow and alleviate anginal symptoms.

A diagnosis of chronic angina is generally made through the administration of several diagnostic tests. Following an initial consultation and physical examination, a physician will generally order a battery of imaging and stress tests to evaluate the condition and functionality of the heart muscle. Typical tests include a coronary angiography and electrocardiogram (ECG) to assess the circulatory function and electrical conductivity of the heart muscle. A stress echocardiogram and treadmill test also may be administered to evaluate the heart's functionality when it is placed under physical strain.

When functioning normally, the coronary arteries continuously supply the heart muscle with oxygenated blood. In the presence of arterial blockage, blood flow becomes restricted and limits the amount of oxygen reaching the heart. During times of physical activity or stress, the heart is forced to pump harder requiring additional blood flow. When circulation is compromised, the lack of oxygenated blood reaching the heart can induce the gradual onset of chest pain and discomfort associated with chronic angina.

Individuals who develop chronic angina may present with a variety of signs and symptoms. Similar to signs associated with a heart attack, the individual may develop heaviness, tightness, or pain that radiates out from the chest to his or her upper limbs and torso. It is not uncommon for individuals to also experience nausea, dizziness, and shortness of breath during an anginal episode. Usually lasting a few minutes, an episode of chronic angina generally requires the administration of a nitroglycerin tablet to alleviate discomfort.

Aside from genetic factors, such as a familial history of heart disease or high blood pressure, certain lifestyle and physiological factors also may contribute to symptom development. Those who are obese, who smoke or who do not get sufficient physical activity may be at an increased risk for symptom development. The presence of a secondary or underlying medical condition, such as anemia or heart disease, also may increase one’s chances for developing chronic angina.

Treatment for this condition generally necessitates the administration of prescription medication to improve arterial functionality and lower blood pressure. Those who experience regular episodes may be given nitroglycerin pills to take as needed to alleviate discomfort. Lifestyle changes may be recommended, including dietary changes, weight loss, and regular exercise, to aid with treating and alleviating underlying conditions, such as diabetes. In instances where compromised arterial function contributes to cardiovascular dysfunction, surgery may be necessary to restore proper blood flow and alleviate anginal symptoms. Surgical approaches may include the use of angioplasty or heart bypass, depending on the severity of the arterial blockage.