Background continued:

• Mr. Harris’s age, sex, family history, and cigarette smoking are enough to put him into the high risk category for CAD. As we shall see, his chest pain is due to angina pectoris so he does have underlying structural heart disease due to coronary atherosclerosis.
• The mechanism responsible for the sensation of angina is complex.
  • There is substantial evidence that the primary mediator is adenosine via the A1 adenosine receptor.
  • Impulses travel along the afferent sympathetic pathways and enter ganglia in the lower cervical and upper thoracic spinal cord (C7-T4).
• Therefore, angina is often referred to the corresponding dermatomes.