What are the causes of spontaneous angina pectoris

Angina pectoris is a very common symptom in life, and there are several diseases that cause this symptom. Angina pectoris indicates that there is something wrong with the heart and should be checked promptly regardless of the severity. Myocardial infarction, coronary heart disease, etc. may cause it.

What are the causes of spontaneous angina pectoris?

The direct cause of spontaneous angina pectoris may be the accumulation of excessive metabolic products in the myocardium under conditions of ischemia and hypoxia, such as acidic substances such as lactic acid, pyruvic acid, and phosphate, or polypeptide substances similar to kinin, which stimulate the afferent fiber endings of the autonomic nerves in the heart, and are transmitted to the brain through the 1st to 5th thoracic sympathetic ganglia and the corresponding spinal cord segments, producing a feeling of pain.

This pain is reflected in the skin area where the spinal nerves are distributed at the same level as the autonomic nerves entering the spinal cord segment, that is, behind the sternum and the front sides of both arms and little fingers, especially on the left side, but mostly not at the anatomical position of the heart. Some people believe that abnormal stretching or contraction of coronary vessels rich in nerve supply in the ischemic area can directly produce pain impulses. Mechanical stimulation of the heart does not cause pain, but myocardial ischemia and hypoxia do cause pain. Angina pectoris occurs when there is a conflict between the coronary artery blood supply and the myocardial blood demand, and the coronary artery blood flow cannot meet the myocardial metabolic needs, causing acute and temporary myocardial ischemia and hypoxia.

What are the typical symptoms of spontaneous angina pectoris?

Spontaneous angina pectoris is a sudden onset of squeezing, stuffy or constrictive pain behind the upper or middle part of the sternum. It may also affect most of the precordial area, radiate to the left shoulder, the anterior and medial side of the left upper limb, and reach the ring finger and little finger. It may occasionally be accompanied by a feeling of fear of impending death, which often forces the patient to stop activities immediately, and in severe cases, sweating may also occur. The pain lasts 1 to 5 minutes, rarely exceeding 15 minutes. Rest or take nitroglycerin tablets, disappear within 1 to 2 minutes (rarely more than 5 minutes). Anemia often occurs when one is physically tired, emotionally excited (angry, anxious, overexcited), exposed to cold, overeating, or smoking, resulting in pale face and cyanotic lips. It may also induce tachycardia or shock. Atypical angina pectoris, the pain may be located in the lower part of the sternum, the left precordial area or the upper abdomen, radiating to the neck, mandible, left scapula or right chest. The pain may come on quickly or only cause discomfort and stuffiness in the left chest.