Angina or angina pectoris is an acute chest pain that develop due to reduced blood flow to the myocardium; it occurs due to many causes such as:

• Partial obstruction of the blood supply to the cardiac muscle.
• Spasm of the blood vessels supplying the cardiac muscle.
• Severe anemia.
• Hypercholesterolemia associated with atherosclerosis.
• Cardiac problems such as arrhythmia or heart failure.

There are many risk factors which predispose to angina or exacerbate the case, such as; smoking, obesity, sedentary life, physical or mental stress as well as chronic health conditions such as diabetes, hypertension and kidney disease.

Reduction of blood flow to the myocardium leads to decreased cardiac muscle oxygenation, which results in many clinical signs, they include:

• Acute chest pain which is felt mainly in the epigastrium; but it may extend to the back, shoulders, neck and jaw.
• Discomfort and tight chest.
• Sweating, pallor, nausea and sometimes vomiting.
• Low blood pressure & bradycardia.

Angina is classified into two main types:

• Stable angina: it occurs after activity (walking, running… etc.). Stable type of angina is manifested with symptoms tend to be mild to moderate and easily managed.
• Unstable angina: it occurs at rest, its associated symptoms are more serious and severe.

Proper diagnosis and assessment of angina requires some diagnostic investigations such as; ECG, Echo Doppler and chest X-ray. For management, vasodilator drugs (nitroglycerin) are the main line of treatment for increasing blood flow and tissue oxygenation. Also Beta blockers or calcium channel blockers are necessary for reducing cardiac output. If medication failed, balloon catheter can be used for vasodilatation and restoring blood flow.