Diagnosis Of Angina

Pain Pattern
1. Location
The pain of angina is usually felt in the center of the chest
over the breastbone, and only rarely over the breasts. Pain in the lower jaw
accompanied by pain in the chest or arms during a walk or
strenuous activity is nearly always due to angina, especially
if these symptoms recur during similar activities.
Sometimes the discomfort is only in the upper arm with a
tingling feeling in the fingers; this pain comes mainly
on exertion as opposed to pain produced, for example,
by a pinched nerve. A pinched nerve will cause similar
discomfort in the arms and fingers when the individual
is at rest, but an activity, such as walking, makes little
difference.
2. Severity and Character
The pain of angina may be mild to moderate and only
occasionally severe. Often it is just discomfort. The
individual may even refuse to use the word pain to describe
the peculiar sensation that feels like a tightness or a
heavy weight on the breastbone. To some it is a burning
sensation; to others it is a feeling of strangulation or
suffocation that fortunately disappears within one to five
minutes of rest, either with the individual standing or
sitting. The pain of angina rarely lasts more than 10
minutes. If an individual has pain similar to that described
and lasts more than 15 minutes, the patient should take
two or three soft, chewable aspirins (80 mg each) and go
immediately to a hospital emergency room.
Activities that Precipitate Angina
These precipitating activities include:
1. Walking up a hill
2. Walking against the wind
3. Running with some associated anxiety for a bus or to a
place, especially while carrying a bag; anxiety is made
more profound if the individual is late and must rush,
thus, there is exertion and emotional stress
4. A brisk walk or similar exertion soon after eating; this
does not include bending and stooping, which can
precipitate indigestion
5. Unaccustomed exertion
6. Emotional distress; for example, bad news, a scare,
anger, rage, nightmares, etc.
7. Pain may occur during overwhelming excitement; for
example, watching your team playing football, hockey,
baseball, basketball, and similar exciting programs
Most important, relief of pain in an individual with
stable angina always occurs within minutes of cessation of
the precipitating exertional or emotional activity. Relief
with nitroglycerin occurs promptly within one to two
minutes.

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