MODEL RELEASED. Angina pectoris. Elderly woman clutching her chest during an attack of angina pectoris. Angina is a severe pain and feeling of constriction in the chest. The pain typically spreads to the left shoulder and down the left arm. Angina is caused by a deficiency in the oxygen supply to the heart muscle. The oxygen deficiency is usually due to obstruction of the coronary arteries due to formation of atheroma plaques (atherosclerosis). Drugs may be used to relieve symptoms by increasing blood flow. More severe cases may require coronary artery by- pass surgery or angioplasty to re-establish blood flow to the heart muscle.