Angina:  spasmodic, choking, or suffocation pain.  The episodic pain of angina occurs when the supply of oxygen to the heart can't meet the heart's needs.

Physical or emotional stress activates the sympathetic nervous system, causing vasoconstriction and increased heart rate, contractility, and blood pressure.  These heighten the hearts oxygen needs.

Angina may occur during stress, exertion (pain will be relieved by rest), or dreaming, or after a heavy meal or exposure to cold.


Increase heart rate

Increase blood pressure

Retrosternal or substernal pain that's described as a feeling of tightness, pressure, heaviness, squeezing, or burning.

Pain that radiates to the lower jaw, neck, shoulder, arm, or hand, usually on the left side.  This pain is generally felt with the retrosternal or substernal pain.



GI distress

Pulmonary congestion

Increase need to void

Bradycardia or tachycardia



Nitroglycerin:  IV or Sublingual

Chest pain should be reported to your doctor immediately


Angina: is usually described as chest pain, and is referred to as angina pectoris.  The cause of this pain is the heart not getting enough oxygen.  To understand how this works, we need to take a brief and over simplified look at the lungs, blood, and the cells of the body. First, the lungs function is to take oxygen from the air we breath and put it into the blood.  The blood then carries the oxygen to all the cells in our bodies.  The cells then use the oxygen to produce energy to complete their various tasks. The pain or discomfort is usually of short duration, lasting 3 to 5 minutes.  The pain goes away when the heart starts getting enough oxygen again.  The effects of a temporary reduction of oxygen is reversible, that is, the cells are not permanently damaged.

Symptoms- the most common is discomfort of the chest, ranging from a feeling of pressure to moderate pain. It is sometimes mistaken for indigestion.  Other common sites are, the lower jaw and the left shoulder and arm.  A person may describe the discomfort with a clenched fist.  White or pale skin, sweating, and difficulty breathing are frequently seen with this disease.


Stable angina is brought on by increased demands but on the heart.  Physical exertion brings it on.  An individual generally knows what activity level will cause the discomfort.

Unstable angina cannot be predicted, it may happen while a person is at rest.  Unstable angina usually indicates a more advanced disease than stable angina.  The arteries carrying blood are no longer able handle enough blood for the heart even at rest.  This is sometimes caused by the arteries of the heart going into spasm.  This is most frequently a result of Atherosclerosis.

Treatment- Nitrates are usually the first line of defense.  They cause the blood vessels to expand and this in turn decreases demand on the heart.  It is easier for the heart to push blood through the expanded vessels. Other medications are often used to decrease blood pressure, decrease heart rate and contractility, and decrease blood volume in the left ventricular chamber of the heart.

Latest Article: Atrial Septal Defect

Atrial Septal Defect:   (ASD)   this congenital defect, an opening between the left and right atria allows shunting of blood between the chambers.  The left atrial pressure normally is slightly higher than right atrial pressure, blood shunts from left to right.  The pressure difference forces large amounts of blood through the defect and leads to right heart...

Related Articles: