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This term refers to midsternal, anterior chest pain due to a partially blocked coronary artery (see figures 53 and 54), often felt as a chest pressure like an elephant sitting on one's chest, spreading to the inner aspect of the upper left arm, neck and upper mid back, lasting anywhere from 5 to 10 or more minutes.
It is precipitated by excitement, exertion, or other stimuli that increase heart muscle oxygen requirements. The threshold for pain is usually fixed, but somewhat variable due to variations in the vasomotor tone and degree of vasospasm (see definition).
The blockage or occlusion of the coronary artery is due to atherosclerosis (see figure 70), which alters the ability of the coronary arteries to dilate. This contributes to the arteries being in vasospasm (see definition), which is abnormal. These arteries have enhanced vasospastic tone.
