Mechanism of Chest Pain in Angina Pectoris

Chest Pain / Angina Pectoris

Chest pain / angina pectoris. Complaints of chest pain in patients with coronary heart disease are most often perceived grievances. And chest pain in patients with coronary artery that has its own characteristics. As with chest pain like pressure, crushed, radiating to the left arm and arise during activity.

Factors causing chest pain / angina pectoris among which:

• Coronary artery spasm.
• Arteriosclerosis.
• Aortic insufficiency.
• Severe anemia.
• Arthritis.

Aside from the above etiologies, there are also other risk factors. Risk factors for angina pectoris is divided into two terms. Ie factors that can be changed (modified) and there is also a risk factor that can not be changed.

As for which is included in the risk factors that can be changed are:

• Hypertension.
• Smoking.
• Hyperlipidemia (diet).
• Less activity.
• Stressor.
• Diabetes Mellitus / DM.
• Obesity / overweight.
• The use of oral contraceptives.

Now that fall into the category of risk factors that can be changed are:

• Gender.
• Age.
• Hereditary.
• Race.
• Personality type.

Complaints of chest pain or angina pectoris is often triggered by activity and some things. So some of the following may result in chest pain complaints among them are:

• Physical work too hard and achieve.
• The presence of stress.
• Emotions.
• A lot of smoke.
• Too full to eat.

In the medical world, the diagnosis of angina pectoris is divided into 3 variants ie stable angina pectoris, unstable angina pectoris, and the last one is kind prinzmental angina (variant angina) with characteristics different.

For stable angina pectoris characteristics, namely:

• Classically associated with the onset of exercise or activities that increase myocardial oxygen demand.
• Chest pain is immediately relieved by rest or stop the activity.
• The duration of chest pain 3-5 minutes and rarely exceeds 10 minutes.
• Onset of chest pain is a need for increased coronary blood flow, for example
• at a time when the physical work or exercise and coronary supply can not meet the needs of the blood flow.

For Unstable angina pectoris characteristics, namely:

• The nature, place and deployment of chest pain can be similar and the same with stable angina pectoris.
• The duration of an attack of this kind could arise on longer than stable angina pectoris.
• Originator may occur at rest or in a state of relatively light activity levels.
• Less responsive to nitrate treatment.
• On the EKG; more often found ST segment depression.
• It could be caused by atherosclerotic plaque rupture, spasm, thrombus or platelet aggregate.
• Often called pre-infarction angina caused by coronary artery atherosclerosis.

Prinzmental angina (variant angina).

• Chest pain or pain occur at rest, often arising in the morning.
• Lasts longer than stable angina pectoris which is about 1-15 minutes sometimes up to 20 minutes.
• Chest pain caused due to atherosclerotic coronary vessel spasm.
• ECG; showed ST segment elevation.
• Likely to evolve into acute myocardial infarction.
• Arrhythmias may occur at a later stage.

The mechanism of the onset of angina pectoris is based on the inadequate supply of oxygen to the cells of the myocardium caused by arterial stiffness and narrowing of the lumen of the coronary arteries (coronary arteriosclerosis). It is not known exactly what causes arteriosclerosis, but it is clear that no single factor is responsible for the development of arteriosclerosis. Arteriosclerosis coronary artery disease is the most frequently found. When the workload of a network increases, the oxygen demand is also increasing. When a need arises in the healthy heart, the coronary arteries dilate and more blood flow and oxygen to the heart muscle. However, if the experience stiffness or coronary artery narrowing due to arteriosclerosis and can not dilate in response to increased demand for oxygen, then there is ischemic (lack of blood supply) myocardium.