The typical patient with angina is a man older than 50 years or a woman older than 60 years of age who complains of chest discomfort, usually described as heaviness, pressure, squeezing, smothering, or choking, and only rarely as frank pain.<<learn more.
When the patient is asked to localize the sensation, he or she will typically place their hands over the sternum, sometimes, with a clenched first, to indicate a squeezing, central, substernal discomfort. Angina is usually crescendo-decrescendo in nature, typically lasts 2-5 minutes, and can radiate to either shoulder and to both arms. It can also arise in or radiate to the back, intercapular region, the root of the neck, jaw, teeth, and epigastrium.
Although episodes of angina are typically caused by exertion (eg. exercise, hurrying, or sexual activity) or emotion (eg. Stress, anger, fright, or frustration) and are relieved by rest, they may also occur at rest and while the patient is recumbent. Nocturnal angina may be due to episodic tachycardia, diminished oxygenation as the respiratory pattern changes during sleep, or expansion of the intrathoracic blood volume that occurs with recumbancy. The threshold for the development of angina pictures may vary by time of day and emotional state. Many patients report a fixed threshold for angina, which occurs predictably at a certain level of activity, such as climbing two flights of stairs at a normal pace. In other patients, the threshold for angina may vary considerably within any given day or day two day.<<learn more
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