Which of the following conditions is associated with a predictable level of pain that occurs as a result of physical or emotional stress?
A. Anxiety
B. Stable angina
C. Unstable angina
D. Variant angina
Correct Answer: B. Stable angina
The pain of stable angina is predictable in nature, builds gradually, and quickly reaches maximum intensity. Stable angina is characterized by chest discomfort or anginal equivalent that is provoked with exertion and alleviated at rest or with nitroglycerin. This is often one of the first manifestations or warning signs of underlying coronary disease.
Option A: Anxiety disorders appear to be caused by an interaction of biopsychosocial factors. Genetic vulnerability interacts with situations that are stressful or traumatic to produce clinically significant syndromes. Anxiety is linked to fear and manifests as a future-oriented mood state that consists of a complex cognitive, affective, physiological, and behavioral response system associated with preparation for the anticipated events or circumstances perceived as threatening.
Option C: Unstable angina doesn’t always need a trigger, is more intense, and lasts longer than stable angina. Coronary atherosclerotic disease is the underlying cause of unstable angina in nearly all patients with acute myocardial ischemia. The most common cause of unstable angina is due to coronary artery narrowing due to a thrombus that develops on a disrupted atherosclerotic plaque and is nonocclusive.
Option D: Variant angina usually occurs at rest—not as a result of exercise or stress. There is a decrease in blood supply to the myocardium generating symptoms like chest pain. The coronary arteries may develop spasm as a result of exposure to cold weather, exercise, or a substance that promotes vasoconstriction as alpha-agonists (pseudoephedrine and oxymetazoline). Recreational drug use, for example, cocaine use, is associated with the development of vasospastic angina, especially when used concurrently with cigarette smoking.
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