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Chest Pain and Angina
Chest pain is also known as angina pectoris. It is one of the most common symptoms of coronary artery disease and is often described as heaviness, pressure, fullness, burning, squeezing, or discomfort in a specific area. However, not all angina pain is in the chest. Angina can also be felt in the arms, back, jaw, throat, and shoulders or may simply be a shortness of breath.
Types of Angina
There are three main types of angina: stable angina, unstable angina, and Prinzmetal’s angina. Talk to your doctor if you experience angina pain in any form.
Stable angina has a predictable pattern of pain. Patients with this type of angina can expect when and how angina pain will occur based on their level of activity.
Unstable angina has no pattern and may indicate that a heart attack will occur soon. If you experience angina pain unrelated to exercise or activity, seek emergency medical attention.
Prinzmetal’s Angina or Variant Angina
Prinzmetal’s angina is the rarest form of angina. It occurs when the coronary artery spasms and can happen while at rest.
Measuring Angina Severity
The Canadian Cardiovascular Society categorizes angina into grades I through IV based on limits to physical activity.
- Grade I
Ordinary physical activity does not cause angina, such as walking and climbing stairs. Angina with strenuous or rapid or prolonged exertion at work or recreation
- Grade II
Slight limitation of ordinary activity. Walking or climbing stairs rapidly, walking uphill, walking or stair climbing after meals, or in cold, or in wind, or under emotional stress, or only during the few hours after awakening. Walking more than two blocks on the level and climbing more than one flight of ordinary stairs at a normal pace and in normal conditions
- Grade III
Marked limitation of ordinary physical activity. Walking one or two blocks on level ground and climbing a flight of stairs in normal conditions and at a normal pace
- Grade IV
Inability to carry on any physical activity without discomfort, angina syndrome may be present at rest
Reducing or Eliminating Angina Pain with TMR
Research has shown that TMR or transmyocardial revascularization can reduce angina pain from grade IV to grade II or better.1 After five years, 88% of TMR patients have shown an improvement by at least two classes and 33% were completely angina free.
Not everyone with angina is candidate for TMR. TMR is a consideration for those patients who suffer from profound physical limitations due to angina where other medical treatments have proven ineffective. Talk to your doctor if you’d like to know more about TMR.
- Allen KB, et al. Ann Thorac Surg. 2004;77(4):1228-34.