Patient was educated on causes and risk factors for angina as follows:

Atherosclerosis

• Deposition of cholesterol plaques on the inner surface of the coronary arteries in individuals with history of atherosclerosis can result in collapse of the coronary arteries, thus compromising blood supply to cardiac muscle and precipitate episodes of angina.

Emotional stress

• Hormones released during stress, such as, adrenaline and noradrenaline, increase the blood pressure, by causing generalized constriction of blood vessels, including the coronaries.
• This will compromise blood supply to the cardiac muscle.
• Also, these hormones increase the work load on the heart, by increasing the heart rate, thus inducing the disproportion between oxygen supply and demand, and consequent angina.

Emboli

• Rupture of lipid plaques in individuals with atherosclerosis can result in dislodgement of fragments of cholesterol and become free floating emboli in the circulation.
• These emboli can obstruct the coronary arteries, compromise blood supply to the heart, and lead to angina.