The diagnosis of coronary artery disease and angina pectoris is clear, but the patient asks me in a strange way: I don’t have any pain at all, how can I call it angina pectoris? So let’s talk about what angina pectoris means in layman’s terms. A simple analogy is that the heart muscle cells are like the wheat seedlings in the field, and our coronary arteries are like the water pipes for irrigation, and angina is a warning that the water pipes are blocked and the wheat seedlings in the field lack water, which is reflected to the brain. Here are a few characteristics of angina to elaborate. 1, the location of angina: the typical location should be in the back of the sternum, but we often say that from the level below the nose to the level above the navel, this range of pain may be the performance of angina, and not only the left side of the chest pain is angina, which also allows many patients to misdiagnosis. Patients with toothache are often found to have severe coronary artery disease; patients with “neck pinching” symptoms are often the manifestation of severe stenosis in the proximal part of the coronary artery; and many patients with perennial “stomach pain” and “stomach discomfort” end up with severe coronary artery stenosis. Many patients with “stomach pain” and “stomach discomfort” for years are found to have severe coronary heart disease. Therefore, I often explain to patients during my check-ups that if pain and discomfort occur in the area below the nose and above the navel, they are at high risk for coronary heart disease (see “What kind of people are prone to coronary heart disease?) The first thing that needs to be ruled out is the possibility of coronary heart disease and angina pectoris, because no other systemic disease is as fast and harmful as coronary heart disease, angina pectoris and myocardial infarction. In addition, the location of angina is generally not a “point”, the patient should not be able to accurately point out the pain point, but a “piece” of discomfort, massage or finger pressure will not improve the symptoms. 2, the cause of angina: angina in accordance with the different causes, can be divided into stable angina and unstable angina. The most common cause of stable angina is exertional, but also the most easily understood, the patient strenuous activity (such as climbing, running, climbing into the wind, etc.) after the symptoms of angina; other triggers include emotional excitement, cold stimulation, satiety, shock, etc.; and quiet state on the onset of angina, is the highest risk of unstable angina performance, often represents the presence of plaque rupture in the coronary arteries, need to go to the hospital as soon as possible. 3, the nature of angina: the typical performance should be behind the sternum crush-like, tight feeling, patients often need to “hold the heart squatting” rest, other performances include chest pressure boulder feeling, chest tightness, breathlessness, shortness of breath, but also often only show a headache, stomach pain or body discomfort, etc., generally does not show a transient “In addition, there is also completely asymptomatic angina pectoris, which is often manifested in patients with long-term diabetes. Clinically we often encounter persistent chest tightness, like “long out of breath” or “deep breathing” patients, often female patients, and finally were ruled out coronary heart disease, considered mostly cardiac neurosis. 4, the duration of angina: angina generally lasts a few minutes to no more than 20 minutes. We often say that chest discomfort for a few seconds or lasts more than half an hour, are not considered angina pectoris. Clinically, we often encounter patients with intercostal neuralgia or frozen shoulder with severe and persistent pain, which are not manifestations of angina pectoris; in addition, for elderly people suffering from herpes zoster, persistent chest pain episodes, before the occurrence of lesions, are often misdiagnosed as angina pectoris, which requires our attention. 5, the regression of angina: angina can be relieved within a few minutes after stopping to rest or after taking nitroglycerin under the tongue. If it is exertional angina, continue to move after the angina is relieved, angina will continue to attack, which is why we often encounter patients climbing a 5-story building need to rest 3 or 4 times. For patients with resting angina, repeated episodes often indicate a myocardial infarction, so timely consultation is essential. In summary, the performance of angina is very variable, but there are still traces, the important thing is to be alert, pay more attention, do not avoid the disease! Do not believe in symptoms! Now the non-invasive imaging is very accurate, is it angina, we can give the answer!