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Angina Pectoris (cont.)

What causes angina?

Coronary heart disease

The most common cause for the heart not getting enough blood is coronary heart disease, also called coronary artery disease.

  • In this disease, the coronary arteries become blocked, narrowed, or otherwise damaged.
  • They can no longer supply the heart with all of the blood it needs.

Most cases of coronary heart disease are caused by atherosclerosis (hardening of the arteries).

  • Atherosclerosis is a condition in which a fatty substance/cholesterol builds up inside the blood vessels.
  • These buildups are called plaques, and they can block blood flow through the vessels partially or completely. Multiple risk factors, particularly:

Coronary artery spasm

Another cause of unstable angina is coronary artery spasm.

  • Spasm of the muscles surrounding the coronary arteries causes them to narrow or close off temporarily. This blocks the flow of blood to the heart muscle for a brief time, causing angina symptoms.
  • This is called variant angina or Prinzmetal angina.
  • This is not the same as atherosclerosis, although some people have both conditions.
  • The symptoms often come on at rest (or during sleep) and without apparent cause.
  • Cocaine use/abuse can cause significant spasm of the coronary arteries and lead to a heart attack.

Other causes of angina

Other causes of angina symptoms include the following:

  • Blockage of a coronary artery by a blood clot or by compression from something outside the artery
  • Inflammation or infection of the coronary arteries
  • Injury to one or more coronary arteries
  • Poor functioning of the tiny blood vessels of the heart (microvascular angina)

When a person has underlying atherosclerosis, spasm, or damage to the coronary arteries, angina symptoms usually are set off by one of the following triggers:

  • Physical exertion or exercise
  • Emotional stress
  • Exposure to cold
  • Decreased oxygen content in the air you breathe (for example flying in an airplane or at high altitudes)
  • Using a stimulant such as caffeine or smoking cigarettes (which lowers the amount of oxygen in the blood)
Medically Reviewed by a Doctor on 5/31/2016

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