Published: 18 Jun 2025

ICD9: 413.9      ICD10: I20.9      ICD11: BA40

"Angina, Ischemic heart disease" is a phrase that describes a chest pain syndrome (angina) that is a symptom of an underlying heart condition: ischemic heart disease (IHD), also known as coronary artery disease (CAD).
Let's break it down:

Ischemic Heart Disease (IHD) / Coronary Artery Disease (CAD): This is the root problem. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, become narrowed or blocked. This is usually due to a buildup of plaque (atherosclerosis) inside the artery walls.

Angina: This is the symptom. It is a type of chest pain, discomfort, or pressure that occurs when the heart muscle doesn't get enough oxygen-rich blood. Think of it as the heart muscle "crying out" because it's being starved.

In short: Angina is the pain caused by the insufficient blood flow to the heart muscle *because* of ischemic heart disease.

Key Points:

Angina is a symptom, not a disease in itself. It signals that something is wrong with the heart's blood supply.
The underlying cause of angina is usually IHD/CAD.
Angina can be a warning sign of a potential heart attack. If left untreated, IHD can lead to a complete blockage of a coronary artery, resulting in a heart attack (myocardial infarction).

Types of Angina:

It's also important to know that there are different types of angina:

Stable Angina: This is the most common type. It occurs predictably during exertion or stress and is usually relieved by rest or medication (like nitroglycerin). The frequency, duration, and intensity of the pain usually stays the same over time.

Unstable Angina: This is more dangerous than stable angina. It is *unpredictable* and can occur at rest or with minimal exertion. The pain is often more severe, lasts longer, and occurs more frequently. Unstable angina is a medical emergency because it indicates a high risk of a heart attack.

Variant Angina (Prinzmetal's Angina): This is a rare type of angina caused by a spasm of a coronary artery, temporarily narrowing the artery and reducing blood flow. It often occurs at rest, usually between midnight and early morning.

Microvascular Angina: This type affects the smallest coronary arteries. It might be associated with changes in the walls or inner lining of the small arteries of the heart that leads to reduced blood flow to the heart muscle.

Symptoms of Angina:

Angina symptoms can vary from person to person, but common symptoms include:

Chest pain, pressure, tightness, squeezing, or heaviness.
Pain may radiate to the left arm, shoulder, neck, jaw, back, or abdomen.
Shortness of breath.
Nausea or vomiting.
Fatigue.
Dizziness or lightheadedness.
Sweating.

Diagnosis:

If you suspect you have angina, it's crucial to see a doctor. Diagnosis usually involves:

Medical History and Physical Exam: Discussing your symptoms, risk factors, and medical history.
Electrocardiogram (ECG/EKG): Records the electrical activity of the heart.
Stress Test: Monitors your heart's rhythm, blood pressure, and breathing while you exercise (or are given medication to simulate exercise).
Echocardiogram: Uses sound waves to create an image of the heart.
Coronary Angiogram: Uses X-rays and a contrast dye to visualize the coronary arteries and identify any blockages.

Treatment:

Treatment for angina aims to relieve symptoms and prevent future heart problems. It typically involves:

Lifestyle Changes: Healthy diet, regular exercise, quitting smoking, managing stress.
Medications:
Nitrates (e.g., nitroglycerin): Relax blood vessels and improve blood flow.
Beta-blockers: Slow the heart rate and lower blood pressure.
Calcium channel blockers: Relax blood vessels and lower blood pressure.
Aspirin and other antiplatelet drugs: Prevent blood clots.
Statins: Lower cholesterol levels.
ACE inhibitors or ARBs: Lower blood pressure and protect the heart.
Ranolazine: Helps to reduce angina symptoms
Procedures:
Angioplasty and Stenting: A balloon is used to open a blocked artery, and a stent is placed to keep it open.
Coronary Artery Bypass Grafting (CABG): A healthy blood vessel is taken from another part of the body and used to create a bypass around the blocked artery.

In summary, "Angina, Ischemic heart disease" means that you are experiencing chest pain (angina) because your heart muscle is not getting enough oxygen due to the narrowing or blockage of your coronary arteries (ischemic heart disease). It is important to see a doctor if you experience chest pain or discomfort, especially if it is new, worsening, or occurs at rest, as this could be a sign of a serious heart condition.