What Causes Angina?

Angina pectoris is a clinical syndrome caused by inadequate coronary artery blood supply, resulting in acute, transient myocardial ischemia and hypoxia. Its hallmark manifestation is paroxysmal chest pain or discomfort. Episodes commonly occur during physical exertion or emotional stress, typically lasting 3–5 minutes each; they may recur daily or several times per day and are more prevalent among males over age 40. So what causes angina pectoris? Below we address this question.

Causes of Angina Pectoris

1. Smoking and alcohol consumption

Smoking and heavy alcohol intake can directly trigger angina pectoris. Toxic substances in tobacco smoke directly irritate the myocardium, potentially inducing coronary spasm and thereby precipitating angina. Conversely, chronic alcohol consumption leads to vasodilation, decreased blood pressure, and tachycardia—factors that collectively increase myocardial oxygen demand and contribute to angina onset.

2. Hemoconcentration

Hemoconcentration may provoke angina. Some patients restrict fluid intake before bedtime or overnight to reduce nocturia; combined with age-related decline in renal concentrating ability and frequent nighttime urination, this results in increased blood viscosity and hemoconcentration. Consequently, systemic vascular resistance rises and cardiac workload intensifies, predisposing to angina.

3. Emotional stress

Intense emotional arousal—especially in older individuals—can significantly stimulate the heart. During anger or agitation, heart rate accelerates, systemic blood pressure rises, myocardial oxygen consumption increases, and coronary perfusion decreases, all of which may precipitate angina. Maintaining stable, calm emotions is therefore essential for cardiovascular health.

4. Unhealthy dietary habits

Excessive consumption of rich, fatty, or heavily processed foods—or habitual smoking and drinking—may impair spleen-stomach function and disrupt normal metabolic processes. Over time, this contributes to stasis and accumulation of pathogenic factors within the heart region, ultimately triggering angina.

Symptoms of Angina Pectoris

1. Crushing chest pain

Patients suddenly experience severe, crushing pain behind the sternum, often accompanied by sensations of suffocation, burning, or heavy pressure on the chest. Pain may radiate to the inner left shoulder, neck, jaw, upper/mid-abdomen, or both shoulders—causing marked discomfort.

2. Shoulder or arm pain

Prior to an angina episode, patients may feel discomfort or pain in the shoulder or arm. This may begin in the left shoulder and radiate to the right arm, or extend further to the wrist or fingers. The pain is typically mild—not sharp—and diffuse rather than localized to a single point. Patients may also report heaviness or weakness in the affected shoulder or arm, making lifting difficult.

3. Prolonged duration

Angina episodes usually persist for several minutes—often up to 10–15 minutes. Brief, fleeting chest discomfort lasting only seconds is unlikely to represent angina. However, if chest pain persists for hours and is accompanied by profound fatigue and profuse sweating, acute myocardial infarction should be strongly suspected.

4. Dental or back pain

Some patients present solely with atypical symptoms such as toothache or back pain.

The above outlines the primary causes of angina pectoris. In daily life, it is vital to maintain a cheerful, tranquil mindset and avoid adverse emotional influences. Balanced work-rest schedules and avoidance of excessive physical strain are equally important. We hope this information proves helpful to you.