The direct factors are likely to produce pain in the case of myocardial ischemia and anoxia in the accumulation of excess pyruvate phosphate metabolites such as lactic acid and other acidic substances; or similar material to stimulate the kinin peptide in the heart autonomic nerve transmission into the fiber endings by a ~ 5 thoracic sympathetic ganglia and the corresponding spinal cord segment transmitted to the brain to produce pain and feeling of this pain is reflected in the spinal cord and autonomic nervous to enter the same level as the distribution segment of the spinal nerves of the skin area that the sternum before the arms and after on both sides with the little finger, especially in the left side of the heart is not in anatomical position and multi-office has been suggested that ischemia in the region rich in nerve supply, abnormal coronary blood vessels can stretch or shrink pain impulse

To be mechanical stimulation to the heart does not cause pain, myocardial ischemia and hypoxia, but the pain is caused when the coronary blood flow and myocardial blood required contradiction between the coronary blood flow can not meet the needs of myocardial metabolism caused by a temporary rapid heart of ischemia and hypoxia that generate angina

The number of myocardial oxygen consumption by the myocardial contraction myocardial tension determined by the intensity and heart rate and therefore popular, “heart rate × systolic blood pressure” (ie, the double product), as indicators of myocardial oxygen consumption is estimated myocardial energy generation require large amounts of oxygen uptake for the myocardial cells of blood oxygen content of 65% to 75% while the uptake of the body while the others only 10% ~ 25% of the normal heart, therefore the absorption of oxygen in the blood is close to the maximum amount of oxygen required to increase further when more difficult from the uptake of oxygen in the blood is only be able to rely on to increase coronary blood flow to provide under normal circumstances, coronary circulation have great reserves of strength of the blood flow to the body’s physiological conditions with significant changes; the intense physical activities, expansion of coronary blood flow may be appropriate to break the 6 ~ 7-fold expansion of hypoxia also makes coronary artery blood flow 4 ~ 5 times Erzhi atherosclerotic coronary artery stenosis or occlusion of some branches when the weakening of its expansionary and reduced blood flow to the myocardium for the blood are relatively fixed, such as reduced myocardial blood supply to the heart usually able to cope with the needs of the rest can be asymptomatic if a sudden increase in cardiac load, such as left ventricular failure such as fatigue excited to myocardial tension increased (cardiac chamber volume to increase ventricular end-diastolic pressure increased) to increase myocardial contractility (systolic blood pressure increased ventricular pressure curve of the maximum pressure to increase the rate of change over time), and increased heart rate and fast Erzhi increased myocardial oxygen consumption increased demand for myocardial blood; or when the coronary artery spasm (eg, humoral regulation of excessive smoke or neurological disorder) is to further reduce coronary blood flow; or in a sudden decrease in blood flow circumstances (such as extreme shock, tachycardia, etc.); heart’s blood supply and demand will intensify the conflict between the heart’s blood supply gradually less severe anemia in patients with angina caused by myocardial blood flow while not reducing the case may be due to reduced blood oxygen-carrying red blood cells caused by insufficient Angina

In most cases, exertion-induced angina often the same “heart rate × systolic blood pressure” value occurs on the level of