Angina: Causes, Risk Factors & Treatments

Angina is an indication of underlying cardiac disorder. It is highly recommended to know the causes, risk factors and treatments for angina.

Angina can be defined as pain, muscle fatigue, or tighteningfelt in the chest region (at or around the heart). The discomfort results mainly from low oxygen supply to the heart tissue which is caused by narrowing or obstruction of coronary vessels. Angina is not a disease, but a symptom of cardio vascular illness that may prove life threatening if no action is taken.

The primary pathophysiological event in angina is the vascular obstruction of coronary vessels because of several reasons, such as vascular degeneration, advanced atherosclerosis, thrombosis, embolism, low oxygen content of the blood or anemia. In untreated or poorly managed cases, risk of severe complications increases, such as heart attack or myocardial infarction, necrosis of blood vessels or even death.

Types of Angina

1. Stable Angina

Stable angina is the chest pain felt after excessive physical activity or in any situation when your heart is working harder than it should be(such as after exercise). This type of pain is chronic in nature and is usually predictable. The pain may last up to five minutes or a little more, depending on the nature of interventions employed to manage angina. Your doctor may prescribe an angina medicine or suggest you to limit the intensity of physical activity in order to alleviate chest pain.

2. Unstable Angina

This kind of angina usually occurs before heart attack or stable angina. Unstable angina does not follow the route of a regular angina and is not related with heavyphysical exercising. It does not succumb after rest or with medication, and the pain can last up to half an hour in duration. Such angina is more serious in nature than stable angina and are directly associated with a higher risk of cardiac damage.

3. Prinzmetal’s Angina

It is the most uncommon variety of angina that presents with most serious symptoms and complications. It may happen when you are rest.

Here is a video link explaining the types of angina with more detail:

Causes of Angina

The primary cause of angina is reduced or no blood flow toward the heart. Cardiac muscles are nourished by coronary arteries that are responsible for carrying oxygen rich blood toward the heart. If any blockage occurs in these arteries; your heart tends to underperform its primary function. When you perform physical work, you heart is burdened and pain of angina is felt. This also explains why many people do not feel chest pain when they rest.

Here are some of the causes of different types of angina.


Stable Angina

Unstable Angina

Prinzmetal’s Angina


  • ŸModerate to severe physical exertion (or even after consumption of heavy meals)
  • ŸSmoking
  • ŸEmotional stress
  • ŸExposure to cooler temperatures.
  • ŸFormation of atherosclerotic plaques
  • ŸPartial or complete occlusion of blood vessel due to blood clots
  • ŸTransient spasm in the walls of coronary vessels due to emotional, hormonal or other triggers

Risk Factors of Angina

  • Smoking

Smoking causes irregular fat deposition in the interior walls of the arteries, leading to advanced atherosclerosis. Therefore, individuals who are chronic or chain smokers have great possibility to experience angina in later stages of their life. People who are exposed to passive smoking are also at a risk.

  • Diabetes

Diabetes is the inability of a person to secrete insulin, leaving large amounts of unconverted glucose in the blood. This can lead to irregular deposition of fats in the walls of artery over time, predisposing the person to angina and stroke.

  • Hypertension

When people are constantly under high pressure, they have higher risk of vascular damage over time. In the healing process of vessel, large collagen and fat deposits can occur, which will become hardened over time. This can further result in obstruction to blood flow, leading to angina.

  • Unhealthy Cholesterol Level

Cholesterol is an element that can narrow arteries. Low density lipid (LDL), a kind of high level cholesterol, is typically classified as bad lipids, because of its tendency to accumulate and clog small arteries. This eventually leaves part of heart hypoxic.

  • Genetics

Coronary heart diseases have the tendency to be carried genetically within family members, so care must be taken in diet and lifestyle by people who are genetically predisposed to the problems.

  • Older People

Elderly population is at much higher risk of developing degenerative changesin the organs, because arteries at that time becomeweak, stiff and narrow. Any significant changes in the biochemical or physical environment of the body can further aggravate the risk of angina.

  • Obesity

Obesity is directly associated with elevated blood cholesterol levels and directly promotes the formation of plaques in combination with collagen and salt, which will stick in small arterioleslater. This can cause direct blockade of blood supply, which can cause heart attack or angina.

Treatment for Angina

1.   Medications

  • ŸNitrates: nitrates dilate blood vessels, which greatly increases the available space or volume for the passage of blood.
  • ŸClot-reducing drugs: drugs, such as aspirin and ticagrelor, are suggested for long-term management of angina patients. These drugs prevent aggregation of blood platelets and increase the flow of blood in narrow vessels.
  • ŸCholesterol-lowering drugs: drugs like statins have function to block the compounds that make cholesterol. Patients who are in need of long-term management of cholesterol should consider statins. Statins also block absorption of cholesterol from intestines and help in reducing body cholesterol levels greatly.
  • ŸBlockers: beta-blockers and calcium channel blockers dilate blood vessels and increase the blood flow towards the heart.

2.   Lifestyle Changes

Certain lifestyle changes can prevent angina attacks and any further complication associated with it. These include exercising regularly, keeping healthy and natural dietary habits, such as intake of diet low in cholesterol and salt and high in antioxidants. Keeping a tab on cholesterol levels and living a life free from stress, smoking and alcohol can minimize the risk of angina greatly.


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