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Angina Pectoris

Related Terms

Angina
Angina Attack
Angina Syndrome
Cardiac Angina
Exertion Angina
Stable Angina
Vasomotor Angina

Differential Diagnoses

Bowel ischemia (lack of blood flow to the intestine)
Cervical spine disease
Cholecystitis (gall bladder inflammation)
Gastroesophageal reflux disease (GERD)
Musculoskeletal pain
Peptic ulcer disease (acid peptic disease)
Pericarditis (inflammation of the lining of the heart)

Comorbid Conditions

Anemia
Diabetes
Heart failure
Hyperthyroidism
Infection
Obesity
Renal failure

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The ability to return to work depends on the type and outcome of treatment, severity of residual symptoms, other medical conditions, and demands of the individual's occupation. The individual's willingness to address correctable risk factors such as smoking, sedentary lifestyle, and obesity will influence the length of disability. For some individuals, cardiac rehabilitation may facilitate return to optimal function.

Duration Trends from Reference Data

DURATION TRENDS

ICD-9-CM: 413, 413.9

Cases	Mean	Min	Max	No Lost Time	Over 6 Months
2055	51	0	305	0.2%	3.8%

Percentile:	5^th	25^th	Median	75^th	95^th
Days:	6	14	31	71	167

Differences may exist between the duration tables and the reference graphs. Duration tables provide expected recovery periods based on the type of work performed by the individual. The reference graphs reflect the actual experience of many individuals across the spectrum of physical conditions, in a variety of industries, and with varying levels of case management. Selected graphs combine multiple codes based on similar means and medians.

Medical Codes

	ICD-9-CM:
	411.1 -	Intermediate Coronary Syndrome; Impending Infarction; Preinfarction Angina; Preinfarction Syndrome; Unstable Angina
	413 -	Angina Pectoris
	413.1 -	Prinzmetals Angina; Variant Angina Pectoris
	413.9 -	Angina Pectoris, Other and Unspecified

Definition



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Angina pectoris is felt as discomfort in the chest or adjacent area and is caused by low blood flow to the heart (myocardial ischemia) that limits delivery of oxygen to the heart muscle during exertion. Usually, blood flow is decreased because of blockage within one or more of the coronary arteries supplying the heart muscle (coronary artery disease). This blockage is typically the result of a gradual clogging of the artery with fatty buildup (atherosclerosis). However, sudden tightening or narrowing of the coronary artery (vasospasm) or severe narrowing of the aortic valve (aortic stenosis) may also interfere with coronary blood flow and cause angina.

Angina pectoris is classified into three basic types: stable angina, in which pain is present only during exertion or extreme emotional distress and disappears with rest; unstable angina, in which the angina pain is either different from regular angina pain, such as occurring more frequently, occurring more easily at rest, feeling more severe, or lasting longer; and Prinzmetal's angina, in which angina occurs at rest, when sleeping, or when exposed to cold temperatures. In the latter type of angina, symptoms are generally caused by spasm of the coronary artery rather than because of actual blockage of the artery by plaque or clots.

Obesity, high blood pressure (hypertension), high cholesterol and lipids in the bloodstream (hyperlipidemia), low blood levels of high density lipoprotein, diabetes mellitus, and a positive family history of heart disease are major risk factors associated with coronary artery disease that may lead to angina. Other risk factors may include low red blood cell count (anemia), irregular heartbeat (arrhythmia), or overactive thyroid gland (hyperthyroidism).

Risk: Tobacco use, sedentary lifestyle and advanced age increase an individual's risk for angina pectoris. Deconditioned individuals who begin strenuous exercise programs also have increased risk.

The incidence of angina over the age of 20 is highest in non-Hispanic black men and women (4.1% and 6.2%, respectively) and lowest in non-Hispanic white men and women (2.6% and 3.9%, respectively) (Alaeddini).

Incidence and Prevalence: Approximately 350,000 new cases of angina pectoris are diagnosed each year in the US (Alaeddini).

Source: Medical Disability Advisor

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