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Causes of Angina

Causes of Angina: Coronary Artery Disease

The most common cause of angina is coronary artery disease. In coronary artery disease, the coronary arteries that carry oxygen-rich blood to the heart muscle are narrowed due to the buildup of fatty deposits called plaque. This is a condition called atherosclerosis. Some plaque is hard and stable, and leads to narrowed and hardened arteries; other plaque is soft and is more likely to break open and cause blood clots. The buildup of plaque on the inner walls of the arteries can cause angina by:
  • Narrowing the artery to the point where the flow of blood is greatly reduced
  • Forming blood clots that partially or totally block the artery.
Narrowing of the arteries usually results in stable angina symptoms. Unstable angina is usually caused by a blood clot that blocks the artery.

Stable Angina Causes

Stable angina is the most common type of angina; it is also referred to as exertional angina. In stable angina, a coronary artery has been severely narrowed due to the buildup of plaque. Severely narrowed arteries may allow enough blood to reach the heart when the demand for oxygen is low (such as when you are sitting). With exertion, like walking up a hill or climbing stairs, however, the heart works harder and needs more oxygen, which it cannot get. Therefore, a person develops symptoms of angina. With rest, the symptoms of an attack improve.
Keep in mind that while physical exertion is the most common cause of pain and discomfort from stable angina, it is not one of the "causes of angina." Instead, it should be considered an angina trigger. The actual cause of stable angina during exertion is not enough oxygen-rich blood to the heart muscle because of a narrowed artery.
Besides activities that place exertion on the heart, such as exercise, hurrying, or sexual activity, other triggers of stable angina symptoms include:
  • Emotion (stress, anger, frustration, fright)
  • Exposure to very hot or cold temperatures
  • Heavy meals
  • Smoking.
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