Doctor's Answers (1)
So coronary artery disease is the cause of angina. Basically, you are talking about pressure on the left side of the chest due to coronary artery issues. Number one, it can be caused by what we call a heart attack, that means it's due to blood rupture and then there is a sudden occlusion of your coronary artery then you present with cold sweat, breathless, nausea, vomiting, etc.
Then there is a second group where there is a narrowing of your artery but it hasn't completely occluded that means patients with 70% narrowing.
Then these patients may get symptoms when they are exerting themselves, or they may have symptoms at rest but when they exert it gets worse, then they have not had the event yet, but the symptoms they get are worsening then they should see a cardiologist to evaluate.
Then the third group of patients can be those with coronary artery spasm as we call it, like cramps. Coronary artery spasm is a bit difficult to diagnose when you go and do the angiogram. There is nothing wrong with the arteries or you find minimal blockage to explain for the symptoms. But the patient may have ECG evidence when they are in pain, but when you go in and see, you don't see anything. So, it could be that they had a spasm, I had such a patient before.
Who are the ones who are predisposed to these? So, some patients can be due to medication, things like opioid-based medication like morphine, because they have actually seen that quite common in the western countries where they do cocaine then they complain of chest pain but does not have anything to do with coronary, its caused by cocaine causing artery wall to spasm.
So basically coronary artery disease, is the majority key cause of Angina, Angina as the name suggests, it just means chest pain due to narrowed coronary artery. So this narrowed coronary artery can be either due to disease or due to blood rupture or due to spasm, our arterial wall is muscular.