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Angina is described as a clinical syndrome of chest pain or pressure that accompanies periods of myocardial ischaemia; it is usually the manifestation of coronary artery disease. It is usually aggravated by activities which increases myocardial demand for oxygen e.g. - exercise and emotional stress (1). The name is derived from the Greek 'agkone' which means strangling.
The mechanism of pain sensation is uncertain: the metabolic products of ischamia stimulate pain fibres which pass to the sympathetic ganglia between C7 and T4. The pain is then referred to the corresponding peripheral dermatomes.
The chest pain is usually a central, constricting discomfort which may radiate to the jaw, neck, or one or both arms and may be associated with shortness of breath.
The Health Survey for England (2006) reported that around 8% of men and 3% of women aged between 55 and 64 years currently have or have had angina (2)
SIGN state that despite a steep decline in mortality from coronary artery disease (CAD) in Scotland over the last 20 years, CAD remains one of the leading causes of death in Scotland, responsible for 7,154 deaths in 2015 (1)
SIGN have outlined the management options in suspected angina (1):