Type of angina Etiology Clinical manifestations

Stable Angina Myocardial ischemia, usually secondary to Provoked by physical exertion or emotional stress
coronary artery disease
Usually lasts a short time (15 minutes or less)

Relieved by rest or nitroglycerin

See Clinical Manifestation section

Unstable Angina Rupture of thickened plague, exposing Unexpected chest pain, usually occurs while
thrombogenic surface resting or with minimal exertion

Angina of increasing frequency, duration or

severity

Pain unrelieved by rest or nitroglycerin

Can lead to a myocardial infarction

Prinzmetals angina Coronary vasospasm, usually in a major Occurs primarily at rest
artery
Triggers include increased myocardial oxygen
demand and increased levels of certain
substances (e.g., histamine, angiotensin,
epinephrine, norepinephrine, prostaglandins).
Can be triggered by smoking.

May occur in presence or absence of coronary

artery disease.

Patient usually has a history of migraine

headaches and Raynauds phenomenon.

Pain is relieved by moderate exercise, or it may

disappear spontaneously. It is usually treated with
calcium channel blockers, nitrates, or both.

Silent angina Ischemia occurs in the absence of any There is objective evidence of ischemia but
subjective symptoms patient reports no pain

Patients with diabetes are at increased risk
of silent ischemia, possibly related to
diabetic neuropathy affect the nerves that
innervate the cardiovascular system.
Nocturnal Angina and Etiology is believed to be the result of
Angina Decubitus increased myocardial oxygen demand
(possible due to increased demand during
REM sleep).
Most clinicians consider this to be a stable
type of angina.
Patients can be monitored (e.g., Holter monitor)
to detect ECG changes as silent ischemia occurs.
Ischemia with or without pain has the same
prognosis.
Occurs only at night; the person does not need to
be sleeping or in the recumbent position to
experience symptoms
Angina decubitus is chest pain that occurs only
while the person is lying down and is usually
relieved by standing or sitting