Talk:Angina

Treatment

The paragraph: "Recently, University of Cincinnati medical researchers in cardiology have tried to use a non-invasive, non-surgical collecting tool to gather harvested erythropoietic bone marrow-based adult stem cells and coax them into regrowing new coronary blood vessels to supply the cardiac muscle's cells (cardiac myocytes) with oxygenated blood, with some success- leading to larger Phase 2 trials."

leaves the impression this is a novel or groundbreaking form of therapy. Gene therapy as this modality of treatment is called is neither one and remains well in investigational phase. It has been around since the 80's (Dr Jeff Isner in Boston was one of its pioneers) and despite initial promising preliminary results (even beyond phase 2 trial) no study has demonstrated benefit remotely in course to become standard therapy anytime soon.

The paragraph is speculative at best and refers to potential therapy in research phase that should have no room in a general article such as this. It smells of self-promotion or at least poor understanding of angina therapy.

I propose its removal. —Preceding unsigned comment added by Compaejopo (talk • contribs) 02:36, 7 September 2008 (UTC)

the remaining material under 'treatment' seems to me to be aimed at practitioners.now,if practitoners are coming to wp for rx info on angina,or, conversely, if wp seeks to provide such info to practitioners, something looks seriously amiss to me. am i wrong? comments? Toyokuni3 (talk) 06:22, 27 March 2010 (UTC)

classes

How about describing the different classes; classic/stable, unstable, prinzmetal, decubitus and cardiac syndrome x?

c

Maybe it's just my feeling but the opening sentence is clumsy and actually not correct:

Angina pectoris is a lack of oxygen supply to the heart muscle, due to a reduced blood flow around the heart's blood vessels

the following lines seem much better:

Angina pectoris is a common symptom of myocardial ischemia (most often chest pain). People with coronary artery disease are most often affected by angina.

Kpjas 16:41, 13 September 2005 (UTC)

Rewording better, but I disagree with the definition: strictly 'Angina Pectoris' is only a symptom (of having a tightening-type chest pain) and the term long-predates the identification of atheromatous ischaemic coronary disease. Hence experiencing a severe spasm of a muscle between the ribs or of heartburn from acid-reflux whilst someone is active may both be cases of angina, but not through cardiac-cause. The most important possibility is of course of reversible cardiac ischaemia on activity. So I propose a tighter initial definition mentioning both the major and lesser causes before the article (approproately) continues to discuss IHD. I welcome comments by others before I have a go at this. David Ruben^talk 12:26, 20 September 2005 (UTC)

I've done some expanding, especially of the diagnosis section (which had not been written), the epidemiology section (which was US-centric) and the treatment section (which did not mention calcium antagonists and completely ignored risk factor modification). Differential diagnosis needs to be expanded, and some things could be tightened. JFW | T@lk 16:16, 20 September 2005 (UTC)....

1911 para needs rewrite - surely??

Hi

This para: "An attack of angina pectoris usually comes on with a sudden seizure of pain, felt at first over the region of the heart, but radiating through the chest in various directions, and frequently extending down the left arm. A feeling of constriction and of suffocation accompanies the pain, although there is seldom actual difficulty in breathing. When the attack comes on, as it often does, in the course of some bodily exertion, the sufferer is at once brought to rest, and during the continuance of the paroxysm experiences the most intense agony. The countenance becomes pale, the surface of the body cold, the pulse feeble, and death appears to be imminent, when suddenly the attack subsides and complete relief is obtained. The duration of a paroxysm rarely exceeds two or three minutes, but it may last for a longer period. (If it lasts more than a few minutes longer than it normally does, this means medical attention is needed immediately and a call for help should be made.) The attacks are apt to recur on slight exertion, and even in aggravated cases without any such exciting cause." is pretty much word for word from the 1911 Britannica. We do not any longer say stuff like "the sufferer is at once brought to rest". Well not in my bit of London anyway, foresooth! Can some nice medical person please render it into English more auitable for this century? It's really quite an important article (yeah yeah I know!) and I am sure it would benefit greatly from a few minutes of your time. I can't do it, but I feel sure it needs doing. Or is it just me???

Thanks, Disapppeared ex-user Old Git. :) 138.37.199.199 11:45, 10 November 2005 (UTC)

Yes, Gonegoneone, I still haven't figured out which departed user you are, but I've fixed the article. There is still more to come, but I need to dip into Pubmed to get a good general review for the references section, and to provide some scientific details on vasospasm vs placque rupture. JFW | T@lk 13:40, 11 November 2005 (UTC)

ST??

In the diagnosis sectiont there is mention of 'elevation of the ST segment'. What's an ST?

It's the interval between the S and T waves, but that's not obvious so I'll add a link. Gccwang

Talk:Angina

Reason: Wouldn't have bothered, but in Abdomnal angina someone refers angina to Angina pectoris and that's not correct. Both refer to "angina" itself. -- Robodoc.at 09:38, 17 February 2007 (UTC)

due to ischemia?

"angina, is chest pain due to ischemia"

If this is true, people can not tell if they are experiencing angina. You can only know what you feel, not whether that feeling is being caused by your heart, ischemia, GI tract, sore muscles, etc.-69.87.204.9 13:30, 12 July 2007 (UTC)

Sounds like bullshit to me.

The term derives from the Greek ankhon ("strangling") and the Latin pectus ("chest")

I believe this is a spurious etymology. Please verify that "ankhon" is even a word native to Greek, and that it means what is claimed here. The most authoritative source I can find aside from American Heritage (which is not authoritative at all), is this obscure journal article: http://links.jstor.org/sici?sici=0097-8507(195610%2F12)32%3A4%3C722%3AGEW%3E2.0.CO%3B2-S

Based on my limited knowledge of ancient Greek, there has never even been a kh aspirate in the language. The closest approximation, letter Ϙ (qoppa), not only didn't survive the discontinuation of Linear B, but it was a labialized voiceless velar plosive kw as in "quick" or "quite" or "queer", rather than a voiceless uvular plosive kh as in "queue" or "Qur'an" or "ankh" (which by the way is a native Egyptian term, not Greek).

The closest indisputably genuine Greek word to this, "ankon", means "elbow", not "strangling".--76.224.100.156 21:58, 23 July 2007 (UTC)

I found my own answer. The word is "anchon", spelled with a chi, not a kappa. It's the transliteration that is wrong, not the etymology itself. --76.224.100.156 22:20, 23 July 2007 (UTC)

Nope. The translit was right. Chi is a kh sound, not a ch one, and is increasingly being transliterated that way. — LlywelynII 03:52, 3 June 2015 (UTC)

Calcium Channel Blocker

I think using an Non-dihydropyridine Calcium Blocker such as "verapamil" will be more effective than "Nifedipine" because,in angina pectoris,myocadia were fully dilated by metabolite accomulated in coronary artery.If you use "Nifedipine",mostly target coronary artery's smooth muscle,it will merely make a change in the artery's diameter. Therefor,I prefere using "verapamil",which target and slow the conduction rate of Atrioventricular node,so the heart rate will be slowed down.In this case,the demond of oxygen will be decreased and most symptom will relieve.

Did I say anything wrong? —Preceding unsigned comment added by 124.122.238.26 (talk) 13:42, 28 December 2008 (UTC)

The discomforts that patients feel are widely varying. Also, on a patient by patient (and additionally, co-morbidity) basis one drug may be more or less effective. Generally the non-DHP CCB's should (in theory) be more effective than DHP CCB's, however amlodipine and nifedipine are effective at stopping angina, and in some situations are preferred to verapamil (and other non-DHP CCB's). --74.179.123.64 (talk) 13:53, 6 October 2010 (UTC)

Zinc

in the paragraph on rx, i don't understand the sentence beginning 'reflecting a shortage of zinc in the diet ---', and i suspect many others don't either. why would this precipitate a decrease in the rda?Toyokuni3 (talk)

I concur: <rda # Zn shortage... SalineBrain (talk) 00:04, 2 August 2009 (UTC)

Why is so much devoted to this spurious treatment anyway? —Preceding unsigned comment added by 165.86.81.20 (talk) 00:36, 15 July 2009 (UTC)

Frequencies?

The last paragraph of the section on diagnosis is unclear to me. Where it says “There has been research which concludes that a frequency is attained when there is increase in the blood pressure and the pulse rate. This frequency varies normally but the range is 45–50 kHz for the cardiac arrest or for the heart failure,” what is it talking about? 68.55.112.31 (talk) 06:26, 15 February 2012 (UTC)

Angina in women

Although, angina is very infrequent in women, when present, it is of significant concern. I think the article needs to incorporate some information on this.

The pathophysiology of angina in males and females varies significantly and it needs to be elaborated from Vaccarino, V. (16 February 2010). "Ischemic Heart Disease in Women: Many Questions, Few Facts". Circulation: Cardiovascular Quality and Outcomes. 3 (2): 111–115. doi:10.1161/​CIRCOUTCOMES.109.925313. PMC 3012351. PMID 20160161. {{cite journal}}: zero width space character in |doi= at position 9 (help) Additional citations can be derived from the inline citations of this resource. Another article Banks, Kamakki (1 February 2010). "Angina in Women without Obstructive Coronary Artery Disease". Current Cardiology Reviews. 6 (1): 71–81. doi:10.2174/157340310790231608. PMC 2845797. PMID 21286281. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help) would also prove useful in this regard.

In females, vasospastic or Prinzmetal angina is the most common cause. Associated facts can be drawn from Sun, Hongtao (28 February 2002). "Coronary microvascular spasm causes myocardial ischemia in patients with vasospastic angina". Journal of the American College of Cardiology. 39 (5): 847–851. doi:10.1016/S0735-1097(02)01690-X. PMID 11869851. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Evolving strategies for the treatment of microvascular angina in women can be derived from Duvernoy, Claire S (1 November 2012). "Evolving strategies for the treatment of microvascular angina in women". Expert Review of Cardiovascular Therapy. 10 (11): 1413–1419. doi:10.1586/erc.12.55. PMID 23244362.

Rosano, GM (1999 May-Jun). "Oestrogens and the heart". Therapie. 54 (3): 381–5. PMID 10500455. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help) is also resourceful. Diptanshu^Talk 18:42, 2 June 2013 (UTC)

Epidemiology

The Epidemiology section of this article needs to be elaborated. Facts and inline citations may be drawn from Epidemiology section of Banks, Kamakki (1 February 2010). "Angina in Women without Obstructive Coronary Artery Disease". Current Cardiology Reviews. 6 (1): 71–81. doi:10.2174/157340310790231608. PMC 2845797. PMID 21286281. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)

Further facts may be drawn from Lang, Iain A.; Galloway, TS; Scarlett, A; Henley, WE; Depledge, M; Wallace, RB; Melzer, D (2008). "Association of Urinary Bisphenol a Concentration with Medical Disorders and Laboratory Abnormalities in Adults". JAMA. 300 (11): 1303–10. doi:10.1001/jama.300.11.1303. PMID 18799442.

Both of these resources have already been added to the list of references for the article. Diptanshu^Talk 20:31, 2 June 2013 (UTC)

Is all angina cardiac

Latest change to article, "angina pectoris is often caused.....". If it's called angina, is it not by definition ischemic cardiac disease causing it? Therefore, "often" should be removed? Ian Furst (talk) 22:42, 14 March 2014 (UTC)

pronunciation

This has always bugged me. Is it "anne-j-EYE-nuh" or "anne-gin-uh", or are both correct. I have been corrected by other physicians after pronouncing it both ways. --74.179.123.64 (talk) 13:56, 6 October 2010 (UTC)

Well, sorry your doctors are such assholes, but proper Latin would be AN-GEE-NA if we were adding things to the lead section. There's no call for it, though. Here, the two pronunciations you gave are the only common or obvious ones in English. Per the OED, either one is fine. Since it's not needful or helpful, NOTADICTIONARY means we leave that for Wiktionary to explain. — LlywelynII 03:52, 3 June 2015 (UTC)

historical treatment

I'm sure most users here just want the most up-to-date information available and including old EB coverage would be a disservice. All the same, for those interested in the historical understanding of this disorder, see:

• "Angina Pectoris" , Encyclopædia Britannica, 9th ed., Vol. II, New York: Charles Scribner's Sons, 1878, p. 29.
• "Angina Pectoris" , Encyclopædia Britannica, 11th ed., Vol. II, Cambridge: Cambridge University Press, 1911, p. 9.

 — LlywelynII 04:20, 3 June 2015 (UTC)

Rewrite for lay ppl

74.60.161.158 (talk) 14:32, 24 July 2015 (UTC)

review in NEJM

doi:10.1056/NEJMcp1502240 JFW | T@lk 06:24, 27 March 2016 (UTC)

History section kaput

The historical section needs fixing. Neither the content nor the format make any sense. Thanks. — Preceding unsigned comment added by 86.154.102.1 (talk) 17:40, 13 May 2016 (UTC)

External links modified

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Merger proposal

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

The result of this discussion was to merge. PriceDL (talk) 09:42, 17 April 2017 (UTC)

---

It was proposed that coital angina be merged into this article over a year ago without a discussion being created. I have now created a discussion but don't really see any issues. PriceDL (talk) 05:29, 4 March 2017 (UTC)

• Yes, definitely merge. This isn't a separate condition. —Hexafluoride ^{Ping me if you need help, or post on my talk} 10:48, 4 March 2017 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Jackhammer esophagus

Hello Jytdog,

I notice that you keep reversing my edit of "Jackhammer esophagus" as being a cause of angina because "ref does not mention angina". Please read this external link carefully, under "Symptoms". Scroll down, and it very clearly says under the first bullet point: "chest pain". Isn't chest pain the same thing as angina? The reason I am so passionate about this is I have just been diagnosed with Jackhammer esophagus. For 25 years I had mysterious chest pains/angina, and no doctor could find the cause until three weeks ago. It turned out to be non-cardiac related, showing up on an esophageal motility study as a pH problem with my esophagus. I am trying to help prevent someone else from having to go through the same 25-year frustration that I did. If it were not for this brilliant gastroenterologist ordering this esophageal manometry test, doctors would still be telling me that my chest pains were "stress related" and "psychosomatic". I think this is a matter of semantics. Chest pain is the same thing as angina. Would others please weigh in on this discussion? Doctors are extremely overworked, and if a diagnosis is not easy, very often they have no motivation or incentive to do a thorough investigation. Instead of arguing semantics, for the purposes of this article, can we consider "angina" and "chest pain" the same thing? Thank you. JGKlein 16:32, 7 July 2017 (UTC)

Thanks for opening a discussion. This article is horrible and I keep trying to get time to fix it based on current MEDRS sources and not getting there. I appreciate your personal interest in the topic and your efforts to improve it but it needs a complete overhaul. The sources you brought were not OK in my view. Others may disagree, and we'll see!

What you are saying, however, is that jackhammer esophagus is a differntial diagnosis and not angina. Hm. Jytdog (talk) 16:46, 7 July 2017 (UTC)

My intention is to help spread the word to non-medically trained people that angina/chest pain can be caused by this obscure, very difficult to diagnose syndrome called Jackhammer esophagus, which I was just diagnosed with. I also have Sjogren's Syndrome, another extremely difficult to diagnose disorder that took over 30 years to diagnose. My intention is not to give a medically expert, definitive answer; I merely want to help frustrated patients make a suggestion to their doctors that this mysterious disorder exists. Patients can suggest the esophageal manometry test to their harried, overworked, doctors, and if it shows up as positive, it can be treated with medication. I am now taking Diltiazem, and it is helping my chest pain. Please consider letting me reinstate my inline citations. You could really help some very frustrated patients. Medicine is not an exact science, and often involves much trial and error. Doctors are human and they make mistakes. Sometimes they need a little help from the patient as a collaborative effort. Thank you! JGKlein 17:12, 7 July 2017 (UTC)

Please see your talk page. Jytdog (talk) 17:18, 7 July 2017 (UTC)

"Not enough" vs. "insufficient"

I hate making a post about something so trivial, but I suppose I should per WP:BRD. The phrase "to not enough" does not feel correct. It's awkward to have a preposition followed by "not enough", whereas "insufficient" is a much better word in terms of flow. "Insufficient" is clear, formal, and I'm unclear as to why it is a problem to use it.

Michelangelo1992 (talk) 12:08, 24 August 2017 (UTC)

To add, I will quote from a reliable source on the use of the word "insufficient", if the lack of a reliable source is the problem. "The dominant cause of [ischemic heart disease] syndromes is insufficient coronary perfusion relative to myocardial demand..." Robbins and Cotran, Pathologic Basis of Disease, 9th edition.

Michelangelo1992 (talk) 12:26, 24 August 2017 (UTC)

We work to write the leads in easy to understand English per WP:MEDMOS. "Not enough" IMO is fine. Doc James (talk · contribs · email) 07:03, 4 September 2017 (UTC)

Britain, America, Germany

In Britain, "angina" refers to angina pectoris more than 99% of the time, I'd guess; whereas in Germany "angina" (more?) commonly means "angina tonsillaris", i.e. tonsillitis. What is the American view, or will it become clear to me if I read the whole page? I ask because a German biography of Mozart says he had angina when he was 9, and the American translator has translated it as angina. Fuficius Fango (talk) 10:29, 4 July 2020 (UTC)