Whenever you mention coronary heart disease, you think of angina! In the opinion of the public, angina should have pain and the painful part of angina must be in the area of the heart, is it really so? We know a lot about angina, but there are still a lot of questions that linger in our minds and are always unanswered. The following we will take a look at angina those not known secrets. Is angina always painful? No! A significant number of patients do not experience significant pain during an attack of myocardial ischemia. The discomfort in the chest is often described in terms such as “a burning sensation”, “a stone on the chest” or “a bandage on the chest”, a feeling of pressure, tightness and tightness. Be careful not to be confused by the name angina, as angina is not necessarily a cramping sensation in the heart. Is angina always located in the precordial region? No! A typical episode of angina is located behind the upper middle sternum or in the left precordial region, and can be about the size of the palm of your hand, often without clear boundaries. It would be a mistake to assume that angina only occurs in the area where the heart is located. When angina attacks, it can radiate to other parts of the body through the visceral nervous system, but not usually to the lower extremities. 1. Radiation to the shoulders, arms and hands on both sides is misdiagnosed as frozen shoulder and cervical spondylosis; 2. Radiation backward to the back is misdiagnosed as thoracic spine and crest and back muscle diseases; 3. Upward emission to the neck, pharynx, jaw, cheeks and teeth is misdiagnosed as pharyngitis, trigeminal neuralgia, dental disease and jaw joint disease; 4. Radiation downward to the upper abdomen is misdiagnosed as stomach disease and liver and gallbladder disease. Is oral nitroglycerin effective necessarily angina pectoris? No! True angina oral nitroglycerin for pain relief can generally be relieved between 1 and 5 minutes. For example, some esophageal diseases such as esophageal spasm also manifest chest pain, and taking nitroglycerin can relieve chest pain, but esophageal pain is more often radiated to the back than angina, so you must consult a cardiologist and related professional doctors for guidance and treatment. Does chest pain always mean angina pectoris? No! Chest pain can be caused not only by the heart, but also by other tissue lesions. The causes of chest pain are complex and diverse, and it is a great challenge for clinicians. If chest pain similar to an angina attack occurs, early consultation with a specialist is recommended. Can a normal ECG rule out angina? No! Some patients who have typical angina symptoms but have normal ECG results think they can rule out coronary artery disease. More than half of the patients with angina pectoris have normal ECG when they do not have angina pectoris. If you do not have angina pectoris when you have an ECG, the ECG is likely to be normal; some patients with coronary heart disease have normal ECG even when they have angina pectoris. Therefore, even if your ECG results are normal, if you have typical angina attack symptoms, you should have further examination, such as coronary angiography, to clarify the diagnosis to avoid delaying the disease.