Walk through angina pectoris

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

Walk through angina is the appearance of anginal discomfort early in the course of exertion which then subsides despite continuation of exertion.

Pathophysiology

The precise underlying mechanism of walk though angina remains unclear.

• It has been speculated that this may be due to an initial increase in coronary vascular tone with a consequent reduction in coronary blood flow at the beginning of the exercise.
• It has also been speculated that recruitment of collaterals may also play a role in the phenomenon.

Diagnosis

Symptoms

• In the majority of patients with obstructive coronary artery disease, the intensity of angina is associated with the intensity of the physical activity. However, a subset of patients have so called walk through angina.

• These patients experience angina early in the course of physical activity (e.g. walking, gardening, climbing, and short running) but the angina then disappears despite continuation of the activity.

Treatment

The treatment is the same as chronic stable angina.

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