Editing Angina (section)

==Signs and symptoms==
{{More citations needed section|date=June 2013}}

[[File:Angina pectoris.png|thumb|left| Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Discomfort can also be felt in the neck, jaw, shoulders, back or arms.]]

Angina pectoris can be quite painful, but many patients with angina complain of chest discomfort rather than actual pain: the discomfort is usually described as a pressure, heaviness, tightness, squeezing, burning, or choking sensation. Apart from chest discomfort, anginal pains may also be experienced in the [[epigastrium]] (upper central abdomen), back, neck area, jaw, or shoulders. This is explained by the concept of [[referred pain]] and is because the spinal level that receives visceral sensation from the heart simultaneously receives cutaneous sensation from parts of the skin specified by that spinal nerve's [[Dermatome (anatomy)|dermatome]], without an ability to discriminate the two. Typical locations for referred pain are arms (often inner left arm), shoulders, and neck into the jaw. Angina is typically precipitated by exertion or emotional stress. It is exacerbated by having a full stomach and by cold temperatures. Pain may be accompanied by breathlessness, sweating, and nausea in some cases. In this case, the pulse rate and the blood pressure increases. Chest pain lasting only a few seconds is normally not angina (such as [[precordial catch syndrome]]).

Myocardial [[ischemia]] comes about when the myocardium (the heart muscle) receives insufficient blood and oxygen to function normally either because of increased oxygen demand by the myocardium or because of decreased supply to the myocardium. This inadequate [[perfusion]] of blood and the resulting reduced delivery of oxygen and nutrients are directly correlated to blocked or narrowed blood vessels.

Some experience "autonomic symptoms" (related to increased activity of the [[autonomic nervous system]]) such as [[nausea]], [[vomiting]], and [[pallor]].

Major risk factors for angina include [[tobacco smoking|cigarette smoking]], [[Diabetes mellitus|diabetes]], [[Hypercholesterolemia|high cholesterol]], [[hypertension|high blood pressure]], [[sedentary lifestyle]], and [[family history (medicine)|family history]] of premature heart disease.

A variant form of angina—[[Prinzmetal's angina]]—occurs in patients with normal coronary arteries or insignificant atherosclerosis. It is believed caused by [[vasospasm|spasms of the artery]]. It occurs more in younger women.<ref name="pmid11869851">{{cite journal | vauthors = Sun H, Mohri M, Shimokawa H, Usui M, Urakami L, Takeshita A | title = Coronary microvascular spasm causes myocardial ischemia in patients with vasospastic angina | journal = Journal of the American College of Cardiology | volume = 39 | issue = 5 | pages = 847–51 | date = March 2002 | pmid = 11869851 | doi = 10.1016/S0735-1097(02)01690-X | doi-access = free }}</ref>

Coital angina, also known as ''angina d'amour'', is angina subsequent to [[sexual intercourse]].<ref name=AHA>{{cite journal | vauthors = Levine GN, Steinke EE, Bakaeen FG, Bozkurt B, Cheitlin MD, Conti JB, Foster E, Jaarsma T, Kloner RA, Lange RA, Lindau ST, Maron BJ, Moser DK, Ohman EM, Seftel AD, Stewart WJ | title = Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association | journal = Circulation | volume = 125 | issue = 8 | pages = 1058–72 | date = February 2012 | pmid = 22267844 | doi = 10.1161/CIR.0b013e3182447787 | doi-access = free }}</ref>  It is generally rare, except in patients with severe [[coronary artery disease]].<ref name=AHA/>