Angina pectoris

Intense thoracic pain with a feeling of suffocation. Pain may radiate from the chest to the left arm, the jaw and/or upper abdomen. The symptoms are caused by reduced blood supply to the heart (ischemia) usually caused by coronary atherosclerosis.

Angina Pectoris is retrosternal pain; i.e. pains that are most often localized to the central part of the chest cage. The pain may radiate to the jaw and arms, and is normally provoked by physical excercise, or after meals, following sexual activity, or exposure to cold weather, and is in most cases abated by rest.

Angina pectoris is the result of inadequate blood and oxygen supply to the heart muscle, caused by reduced perfusion of the coronary arteries of the heart. In most cases the reduced perfusion is caused by atherosclerosis, which is why angina pectoris is often associated with thrombosis and impaired cardiac function. People who suffer from angina pectoris have occasional attacks of varying frequency, and the intensity of the pain is extremely restrictive to their level of physical activity. Often the convulsive twinge in the region of the heart is associated with shortness of breath, and a feeling of being drained of strenght, together with nausea, irregular pulse, and cold sweat.

In many cases, angina pectoris is a warning signal of increasing occlusion of the coronary arteries of the heart, and in the worst cases, a blood clot or thrombosis is formed in one or more of the sclerotic coronary arteries that seal off the vessel and block the flow of blood to the heart mucle (acute myocardial infarction). Angina pectoris can be caused by bad eating habits; following a diet with a high relience on animal fats has a strongly promotive effect on atherosclerosis.

Many who experience their first attack of angina pectoris are afraid that they are having a heart attack (Coronary thrombosis). The reason for this confusion is that the two conditions have the following in common:
  • Can be caused by the formation of a sticky plaque on the inside of the coronary arteries (atherosclerosis). The plaque occludes the vessels and blocks the flow of blood to the heart, which results in chest pains that may radiate to involve both the arms, the shoulders and/or the neck.
  • Can follow from intense physical activity.
  • Most often affects men in their fifties or older, and postmenopausal women.
But their are also differences between the two conditions, and these are worth noticing:

  • A Coronary thrombosis results in cardial tissue damage, the formation of an infarction. Angina pectoris does not have this effect.
  • In the case of Angina Pectoris, rest or sublingual administration of nitroglycerine effectively relieves the condition; such an intervention has no effect on coronary thrombosis.

Factors that contribute to the etiology of angina pectoris include high blood pressure, obesity, diabetes, increased cholesterol level, and a genetic disposition to atherosclerosis and cardio-vascular disease.


General advice on disease prevention and a healthy lifestyle can be found in the library article "General Advice - for healthy as well as for ill ones" in the VitaHealth section under Focus Articles. You can also test your health by taking our "Health Check".

Although angina pectoris should not neccessarily be interpreted as a sign of imminent danger (there are examples of healthy young people in perfect physical shape having fits of angina pectoris at one single, or at rare occasion(s)), the pain is fundamentally a sign that something is wrong with the blood and oxygen supply to the heart.

Being a cardiovascular disease, the prime preventive measurement against angina pectoris is naturally to avoid things that are damaging to the heart and circulation, such as smoking, alcohol, and an unhealthy diet. One can benefit from eating substantially more fresh fish, so that one can be sure to get enough of the vital omega-3 fatty acids that change the composition of fats in the blood stream and thereby reduce the risk of atherosclerosis.

One can also benefit from taking dietary supplements or natural remedies with vessel dilative effect, such as Ginkgo biloba or pycnogenole. Make sure to exercise regularly; it is a good idea to construct an exercise program in concert with the family physician, to determine whether or not there should be limits to the intensity of the exercise program.

Abandon hard liqour and tobacco. The damaging effects of tobacco smoke is both due to a directly constrictive effect of nicotine on the blood vessels resulting in reductions in blood flow, and the fact that there are litterally thousands of damaging agents in tobacco smoke promoting the generation of free radicals which oxidize the fat in the blood and partake in the generation of atherosclerosis and cell damage.

Be aware of the provocative effect of cold or windy weather on angina pectoris, and avoid strenous physical activity or psychologic strain, since it is damaging to the heart. Also seek to control strong emotional stress, like anger and frustration.

Herbs that are beneficial to the condition are

  • Ammi Visnaga - which is widely used against angina pectoris and other cardiac disease, since it has a dilative effect on the coronary arteries.
  • Arjuna - a widely used tonic against conditions related to impairment in cardial blood supply.
  • Motherworth - used against pains in the region of the heart. Also has a tranquillizing effect.
  • Garlic - counteracts clotting of the blood and has a curative effect on cardiovascular disease.
  • Hawthorn - relaxes and dilates the arteries, especially the coronaries, and relieves angina symptoms.
  • Night-blooming cereus - stimulates cardiac function and is offered as a cordial during convalescence from heart attacks.
  • Palette leaves - dilates the blood vessels, stimulates the heart, and lowers the blood pressure.
  • Squill - contains cardioactive glycosides that have a stimulative effect on the heart, and are quick-acting.
  • Strophanthus - also contains cardio-active glycosides that reduce the frequency of the heartbeat and improves cardiac function. To be taken according to homeopathic tradition or under professional guidance and control.
The amino acid Carnitine reduces the total amount of blood cholesterole, and especially lowers the damaging VLDL- and HDL cholesterol, while increasing the beneficial HDL cholesterol. It also has a positive effect on irregular heart rhythm and decreases the frequence of angina pectoris attacks, increases the stress-coping ability and improves the tolerance to physical activity in people suffering from coronary artery disease. Experiments on animals have shown that heart attacks drain the tissue of this amino acid, but that fast and sufficient supplementation can have life-saving effects. Carnitine boosts the energy resources of the body and dilates the blood vessels and by doing this, the amino acid also has a lowering effect on the blood pressure.

The amino acid Taurine keeps fatty acids and cholesterole in their liquid form and counteracts pottasium deficiency, whereby it has a protective effect on the heart muscle.

Regarding the essential fatty acids (EFA):

Omega 3 can be found in linseed, cod-liver oil, fatty fish, walnuts, rape, purslane, pumpkin seeds, green vegetables, and wheat germ. 1 tbsp. of cod-liver oil a day or 1 tsp. of grinded linseed or walnut oil every morning is cheaper than fish oil capsules. If needed one can add a couple of capsules of vitamin E to the linseed oil to avoid rancidity.

Omega 6 can be found in blackcurrant, borage, and in cold pressed maize-, rape-, sesame-, sunflower-, thistle-, and evening primrose oil and seeds.


Always be examined by a medical practitioner before initiating self treatment of this and related diseases. The limits to exercise should be discussed with the family practitioner. Never continue to exercise after having experienced symptoms!


Angina pectoris can be present in totally healthy people, without it being a sign of imminent danger.

Also see "Atherosclerosis", "Blood pressure problems", "Cardiovascular diseases", "Cholesterol problems", "Coronary thrombosis", "Diabetes", and "Overweight".

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