Which condition presents as chest pain or discomfort during activity or emotional stress that is relieved by rest?

• A. Stable Angina
• B. Unstable Angina
• C. Prinzmetal Variant Angina
• D. Aortic Dissection

Answer: (A)

Chest pain with activity that gets better with rest is a classic presentation of stable angina. The underlying idea is a fixed narrowing of a coronary artery from atherosclerotic plaque. When you exercise or are emotionally stressed, the heart muscle needs more oxygen, but the narrowed vessel can’t sufficiently increase blood flow, leading to transient ischemia and chest discomfort. Rest lowers the heart’s oxygen demand, and nitrates can help by dilating veins to reduce preload and improve blood flow, so the pain subsides.

This pattern differs from unstable angina, where chest pain can occur unpredictably and may happen at rest or worsen, signaling a higher risk problem. Prinzmetal (variant) angina is due to coronary vasospasm and often occurs at rest with transient ST elevations. Aortic dissection presents with sudden, severe, “tearing” chest pain and often pulse or blood pressure abnormalities, not the exertional pattern described here.