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disease information

Angina

Causes of Angina

In most cases, the main causes of angina are coronary artery disease or vasospasms (spasm of the arteries).

In healthy arteries, enough blood is supplied to your heart so that it can reach its maximum output level without you experiencing any pain. If you have coronary heart disease the arteries that feed the heart with oxygen become damaged. In order to heal the damage the body begins to line them with fatty deposits, also known as plaque or atheroma. These deposits tend to form gradually over several years and can occur anywhere within the coronary arteries. Their build up within the arteries is known as atherosclerosis.

In stable angina, the plaque that forms on the arteries is hard and stable, causing a general narrowing of the arteries and a restriction of blood flow to the heart. In other cases, the plaque is soft and flexible and is more likely to break open.5 In most cases of unstable angina the plaque breaks open and a blood clot forms on top of it via platelets that stick to the opening. This clot restricts the flow of blood to the heart and causes angina, which is why unstable angina can happen even if you are at rest. 5, 4, 1

In variant angina, the narrowing of the coronary arteries is caused by contraction of the smooth muscle tissue in the vessel walls, rather than directly by atherosclerosis. This constriction then stops the blood from freely flowing to the heart, which results in sudden pain. Variant angina can be caused by cardiovascular disease, but can also be caused by exposure to cold temperatures, emotional stress, medication that causes a constriction of the blood vessels, smoking, or the use of recreational drugs such as cocaine.6

In general, an unhealthy lifestyle can lead to you developing either stable or unstable angina as a result of high blood cholesterol levels and high blood pressure. You are at an increased risk of developing angina if you are one of the following:

  • Diabetic
  • Smoker
  • An unhealthy eater
  • Overweight
  • A heavy drinker
  • Inactive, i.e. not participating in regular exercise
  • In a family with a history of the disease
  • Male
  • Middle aged or older
  • A sufferer of high blood pressure


Although the common causes of angina are outlined above, the condition can also be caused by the following:

  • Constriction of the coronary arteries by external pressure against the chest cavity
  • Infected or inflamed coronary arteries
  • Anaemia, or a deficiency in the number of red blood cells in the blood
  • Abnormal heart rhythms 1

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Last Updated 01/05/2009 14:04:15
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