Walk through angina pectoris

Walk through angina is the appearance of anginal chest discomfort early in the course of exertion which subsequently subsides despite continued exertion.

• The precise underlying mechanism of walk though angina remains unclear.
• It has been speculated that walk through angina may be due to an initial increase in coronary vascular tone with a consequent reduction in coronary blood flow at the beginning of exercise.
• It has also been speculated that recruitment of collaterals may also play a role in the walk through angina phenomenon.

In the majority of patients with obstructive coronary artery disease, the intensity of the anginal pain is proportional to the the intensity of physical activity, and the pain only subsides once physical activity ceases. However a subset of patients have walk through angina. Although these patients experience angina early in the course of physical activity (e.g. walking, gardening, and short running) it dissapears despite continuation of physical activity.

The treatment is the same as in chronic stable angina.

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