Coronary artery disease (CAD) is frequently the cause of angina. In coronary artery disease, arteries that supply the heart with blood narrow when deposits accumulate on the inside of the artery. These deposits are called plaques. The narrowing makes it much harder for blood to carry oxygen to the heart. In arteries that are already narrow, anything that would reduce blood flow suddenly, for example, a blood clot, can have a dramatic effect on the blood's ability to get to the heart. Sudden chest pain-angina-can occur, indicating that a heart attack may be imminent. Anemia, in which there are not enough red blood cells to carry oxygen in the blood, can also contribute to angina.
A rare type of angina, variant angina, is the result of a coronary artery spasm. Use of cocaine, nicotine, and amphetamines can cause coronary artery spasms, and sometimes they are caused by other diseases such as lupus.
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