Expansion
Three features define typical angina
Expansion
The three features
- Constricting discomfort in the front of the chest, neck, shoulders, jaw or arms
- Precipitated by physical exertion
- Relieved by rest or nitrate within about 5 minutes
All three = typical angina. Two = atypical. One or none = non-anginal chest pain.
Canadian Cardiovascular Society grading
- I - angina only on strenuous exertion
- II - slight limitation, angina on walking uphill or more than two blocks
- III - marked limitation, angina on walking one or two blocks
- IV - angina at rest or on any activity
Named variants
- Stable - predictable, exertional, unchanged for months
- Unstable - new, at rest, or increasing in frequency or severity. An acute coronary syndrome
- Prinzmetal (variant) - coronary spasm, at rest, often at night, with transient ST elevation, and treated with calcium channel blockers rather than beta blockers
- Decubitus - on lying flat, associated with heart failure
- Syndrome X (microvascular) - typical symptoms with normal coronary arteries
Features making angina unlikely: pain that is continuous, pleuritic, positional, reproduced by palpation, or associated with swallowing.