Using the acronym, you quickly learn that Mrs. Allen's chest discomfort started when she got up to use the bathroom. It's located in her epigastric area and feels like indigestion accompanied by nausea, light-headedness, and diaphoresis. The discomfort doesn't radiate to any other area. She says that she's never had this kind of pain before and that she's starting to feel better now that she's lying down. Stable angina is caused by intermittent myocardial ischemia caused by vasospasm in coronary arteries that may or may not be narrowed by atherosclerotic plaque.
Angina pain has a characteristic pattern for each patient.
Some patients report that the pain radiates to the neck, jaw, left arm, or between the shoulder blades. Symptoms of stable angina are exacerbated by activity and relieved by rest and sublingual nitroglycerin. Angina is considered unstable if symptoms occur unpredictably or if previously stable symptoms become more intense, last longer, or radiate to a different location than usual. It indicates severe coronary vessel narrowing from atherosclerotic plaque. Because atherosclerotic lesions are inflexible, they limit the vessels' ability to dilate in response to nitroglycerin.