Angina pectoris is caused by transient myocardial ischemia due to decreased coronary flow, manifested as episodic retrosternal pain, smothering and choking, etc.
1 Overworked angina: A transient attack of chest pain is induced by exertion, heavy meals, exposure to cold, or emotion.
The typical manifestations are sudden attacks of retrosternal constricting oppressive pain or gripping pain.
The pain commonly radiates to the left shoulder and left arm, accompanied with cold sweat.
The pain lasts 1-5 minutes and can be relieved by resting or by placing a nitroglycerin tablet under the tongue.
Overworked angina can be divided into incipient type, stable type and increase type.
In incipient type the duration of the illness is within one month. In stable type, the state of illness can be stable for a long time.
The episodes have a definite regularity.
In increscent type both the incidence and the severity of the attack increase, indicating the unstableness of the disease.
2 Spontaneous angina: The episodes are not related to exertion. The attack may occur in the recumbent position or during sleep, accompanied with restlessness, fright and hypertension.
The symptoms persist longer and become more severe which could not be relieved by nitroglycerin.
3 Variant angina is a special type of angina pectoris. It is considered that the attacks are related to the spasm of the major one of coronary arteries.
It symptoms are similar to those of spontaneous angina. Many attacks may occur cyclically in a day.
During the episodes ECG show ST-segment elevation.