All about angina and its causes

What causes angina? Revered consultant interventional cardiologist Dr Simon Wilson goes into expert detail in order to answer this question - and more - in this informative article.

What is angina?

Angina, also known as angina pectoris, is a type of chest pain or discomfort. It happens when the heart muscle doesn’t receive enough oxygen-rich blood. It’s often described as a squeezing, pressure, heaviness, or tightness in the chest. Angina can vary in severity and may feel like indigestion or heartburn.

What are the main causes of angina?

Coronary artery disease (CAD)

The most common cause of angina is coronary artery disease, a condition where the coronary arteries that supply blood to the heart become narrowed or blocked due to the buildup of plaque. This restricts blood flow to the heart muscle, leading to angina symptoms.

Atherosclerosis

Atherosclerosis is the process of plaque buildup in the arteries. This includes the coronary arteries. Plaque consists of cholesterol, fat, calcium, and other substances that can narrow or block the arteries, reducing blood flow to the heart and causing angina.

Risk factors

Several risk factors can contribute to the development of angina, including:

• Smoking: Tobacco use damages the blood vessels and increases the risk of atherosclerosis.
• High blood pressure: Hypertension puts added strain on the heart and blood vessels, increasing the risk of coronary artery disease.
• High cholesterol: Elevated levels of LDL cholesterol (often referred to as "bad" cholesterol) can lead to plaque buildup in the arteries.
• Diabetes: Diabetes is associated with an increased risk of developing coronary artery disease.
• Obesity: Excess body weight can lead to high blood pressure, high cholesterol, and diabetes, all of which are risk factors for angina.
• Lack of physical activity: Sedentary lifestyle habits contribute to poor cardiovascular health and increase the risk of angina and coronary artery disease.

Other causes

In addition to coronary artery disease, other conditions and factors can contribute to angina, including:

Coronary artery spasm

Temporary constriction or tightening of the coronary arteries can reduce blood flow to the heart, leading to angina.

Anaemia

Reduced oxygen-carrying capacity of the blood due to low red blood cell count can cause angina symptoms.

Stress

Emotional stress or physical exertion can increase the heart's demand for oxygen-rich blood, triggering angina in individuals with underlying coronary artery disease.

Can angina be prevented?

Angina is a common symptom of underlying heart conditions, particularly coronary artery disease. Reduced blood flow to the heart muscle due to narrowed or blocked coronary arteries is the primary cause of angina. Atherosclerosis, a buildup of plaque in the arteries, is the main mechanism behind coronary artery disease.

Managing risk factors such as:

• smoking;
• high blood pressure;
• high cholesterol;
• diabetes;
• obesity, and;
• lack of physical activity

is essential in preventing angina and associated heart conditions.

Understanding the causes of angina can help patients and healthcare professionals identify and address underlying heart health issues effectively.

Concerned you may be experiencing angina? Arrange a consultation with Dr Wilson via his Top Doctors profile.