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Heart surgeon, thoracic surgeon

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Stable angina

Alexey Portnov, medical expert
Last reviewed: 23.04.2024

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Stable angina is a chronic heart disease caused by the inability of the narrowed coronary arteries to provide the necessary increase in blood flow with an increase in the work performed by the heart.

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What causes stable angina?

When the atherosclerotic plaque narrowing the diameter of the main coronary artery by 70% or more, the reduced blood flow may still be sufficient to ensure low myocardial oxygen demand at rest, but not sufficient to increase this demand under the influence of physical or psychoemotional load. The lower the throughput of the coronary arteries, the less work that can be performed without the development of ischemia. The level of stress causing an attack of angina is the most important criterion in determining the severity of coronary disease.

How is stable angina manifested?

Stable angina is felt by the patient as compression, pressure, burning, piercing pain or numbness localized behind the sternum, with irradiation to the left shoulder, scapula, neck or lower jaw. These manifestations occur with physical activity and require a decrease in its intensity or complete cessation. The duration of such seizures, as a rule, does not exceed ten minutes and seizures are similar to each other. On the basis of the tolerance of physical activity, stable angina is divided into functional classes.

I class. Ordinary physical loads are transferred well, angina attacks occur only at high loads.
II class. There is a small restriction of usual physical activity. Stable angina occurs when walking on a flat spot over a distance of more than 500 meters or when climbing stairs to more than one floor.
III class. There is a marked restriction of normal physical activity. Stable angina at walking at a normal pace in a level place at a distance of 100 to 500 meters and / or when climbing the stairs no more than one floor.
IV class. The pains occur even with small physical exertion (walking on an even place at a distance of less than 100 meters). Characteristic attacks of angina at rest.

Treatment of Stable Angina

All that goes beyond these four classes should be regarded as unstable angina, begin intensive therapy, and hold it until the opposite is proven.