Stephen J. Schueler, M.D.

Heart Chest Pain Underlying Cause

Angina is caused by diseased coronary arteries. The coronary arteries supply the heart muscle with blood, which carries oxygen and nutrients to the heart muscle.

The three main coronary arteries are:

  • Right coronary artery
  • Left coronary artery
  • Posterior circumflex artery

Anatomy examples:
  • Coronary angiogram
  • Front view of the heart and coronary arteries
  • Back view of the heart and coronary arteries

The coronary arteries become blocked by a process known as atherosclerosis, which is also called hardening of the arteries. When the arteries become blocked to the point that they can no longer supply the heart with adequate oxygen (often during physical activity), the result is angina.

The process of atherosclerosis includes:
  • The inner wall of the artery becomes damaged by changes in blood flow, infection, smoking, diabetes, or high blood pressure.
  • As the wall or the artery attempts to repair itself, cholesterol builds up on the inside surface of the artery, forming a plaque.
  • Plaques narrow the inside of the arteries, which reduces blood flow. This can lead to blood clot formation inside the vessel.


Continue to Heart Chest Pain Types

Last Updated: Nov 16, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Heart Chest Pain References
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  4. Parker JO. Angina pectoris: a review of current and emerging therapies. Am J Manag Care. 2004 Oct;10(11 Suppl):S332-8. [15603242]
  5. Scheidt S. Treatment of stable angina: medical and invasive therapy--implications for the elderly. Am J Geriatr Cardiol. 2005 Jul-Aug;14(4):183-92. [16015059]
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