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Lateral angina: symptoms, treatment

by Josephine Andrews
Published: Last Updated on 364 views

Lateral angina is a special form of acute pharyngitis. It shows similar symptoms, such as a severe sore throat, but is relatively rare. People who have had their tonsils removed are particularly likely to get it. Read all about the typical signs and how to treat lateral angina properly here.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.


quick overview

  • Symptoms: pain when swallowing and in the throat, coughing, exhaustion, fever, swollen side cords (lymphatic vessels) and lymph nodes, earache, nausea and skin rash possible in children
  • Causes: Virus infection of the upper respiratory tract, viruses first attack the mucous membrane of the nose and then that of the throat, bacteria multiply on damaged mucous membranes. Lateral angina transmits from person to person.
  • Therapy: bed rest, lozenges, gargling solution, home remedies such as warm neck wraps, steam inhalation, drinking a lot (herbal tea), antibiotics in severe cases
  • Diagnosis: visual inspection of the upper pharynx to determine whether side cords are red and swollen and have white dots, swab of the pharyngeal mucosa
  • Prognosis: Usually three to six days, sometimes inflammation of the middle ear, effusion in the tympanum or pus in the throat, rarely rheumatic fever, inflammation of the kidneys, the heart muscle or the lining of the heart
  • Prevention: Strengthen the body’s defences, for example through a healthy diet rich in vitamins, exercise in the fresh air, hardening through visits to the sauna and alternating showers

What are the symptoms of collateral angina?

A lateral angina usually first manifests itself with difficulty swallowing and a scratchy throat. Then comes a dry cough. Under certain circumstances, this develops into a severe dry cough.

In addition, symptoms such as exhaustion, fever and a general feeling of being unwell occur with side strand angina. Headaches and body aches are also possible.

The lymph nodes in the neck and under the jaw may be swollen. In milder cases, the swelling can only be felt, in severe cases it is even visible from the outside. When palpating the neck, pressure pain usually occurs.

Other symptoms than acute sore throat?

The symptoms of lateral angina and those of normal throat inflammation (pharyngitis) do not differ much from each other at first glance. However, symptoms such as a sore throat are often more pronounced in side-string angina than in pharyngitis.

In the side strand angina, the inflammation extends deep into the throat, while in pharyngitis it usually only extends to the tonsils. Lateral angina primarily affects people who have had their tonsils removed.

The inflammation is not stopped here in the upper throat area, but continues. As a result, the throat becomes more swollen, swallowing is difficult and the pain is more intense than with a sore throat.

Other possible symptoms

If the side cords are severely inflamed, some sufferers complain of earache or develop a middle ear infection (otitis media). It is also possible that a yellowish-white mucus forms in the throat.

symptoms in children

In children, a side strand angina may be atypical: the young patients complain of nausea or abdominal pain, and vomiting sometimes occurs. In addition, a rash resembling scarlet fever occasionally occurs. If these symptoms occur, a (repeated) visit to the doctor is advisable.

Causes and risk factors of lateral angina

The cause of lateral angina is usually a viral infection of the upper respiratory tract (common cold). Viruses usually attack the nasal mucosa first and cause inflammation of the nasal mucosa (rhinitis or runny nose). From there, the viruses spread to the pharyngeal mucosa (pharyngitis or pharyngitis).

Bacteria – mostly streptococci, staphylococci or pneumococci – now find good conditions to multiply on the mucous membrane that has been damaged in this way.

The cause of chronic side-string angina is suspected to be excessive tobacco and alcohol consumption. A chronic course is also possible if people are constantly exposed to dust or breathe permanently through their mouth.

Is lateral angina contagious?

At the beginning of the disease, a lateral strand angina is contagious. The doctor will determine if this is the case. He takes a smear from the mucous membrane of the throat to examine it more closely. If pathogens are detectable in the smear, the patient is contagious.

In the case of treatment with home remedies, this is usually the case for five days after the onset of the disease, and in the case of treatment with antibiotics, this is usually only the case for two days.  

The transmission of the pathogen takes place via a droplet infection (coughing, sneezing) from person to person. It is advisable that those affected have direct contact with as few people as possible. For example, healthy people should not drink from the same glass as sick people.

How is lateral angina treated?

A side strand angina usually heals on its own without problems. Patients should be on bed rest during this time.

Throat medications such as lozenges, gargling solutions or sprays with anesthetics (local anesthetics) are sometimes used to relieve the symptoms. Since the majority of cases of acute sore throat are viral infections, over-the-counter pharyngeal therapy with antibiotics for self-treatment is not indicated.

home remedies

Well-known home remedies for sore throats include warm neck wraps, milk with honey, and steam inhalation with chamomile tea. It is important to drink a lot to flush out the virus faster. Warm herbal teas (such as sage or also with ginger ) may help to promote blood circulation and thus accelerate the removal of inflammatory substances.

Home remedies can at best complement conventional medical treatment, but cannot replace it. Talk to your doctor about how you can best support the therapy yourself.

Symptoms such as fever and difficulty swallowing should subside after three to six days. If this is not the case, another visit to the doctor is indicated. The doctor only prescribes antibiotics in severe cases.

What is a lateral angina?

The so-called side cords are the lymph channels in the throat, which run from top to bottom along the back wall of the throat. Since these lymphatic channels are located on the right and left side of the throat, doctors also speak of an inflammation as angina lateralis (lateralis = on the side).

Inflamed side cords are swollen, red, and dotted with white dots. The side strand angina occurs unilaterally or bilaterally.

Special case of chronic side strand angina

The chronic side strand angina differs from the acute variant. An isolated chronic side strand angina is very rare, it usually occurs in connection with chronic pharyngitis.

The first signs of chronic side-string angina are a dry, hacking cough and the constant feeling of having to clear your throat for several weeks. When coughing, a tough phlegm is often released.

investigations and diagnosis

If a lateral angina is suspected, the doctor first asks about the medical history (anamnesis) and then about the patient’s symptoms. Suspicious symptoms include signs of a cold and pain radiating to the ears.

This is followed by the physical examination. The doctor looks into the upper pharynx and checks whether the lateral strands are thick and reddened and dotted with the characteristic white dots.

The doctor also performs an otoscope by looking into the ear with an otoscope. The lateral strands lie near the Eustachian tube (tuba auditiva). This tube connects the pharynx with the ear and equalizes the pressure when speaking or swallowing. If the side cords swell significantly, the Eustachian tube expands onto the middle ear and thus disrupts the pressure equalization. Earache or even a middle ear infection (otitis media) are possible consequences.

In addition, the doctor takes a swab of the pharyngeal mucosa with a cotton swab to determine the cause of the inflammation. If there is yellowish-white mucus, this indicates a bacterial infection.

If bacteria are actually the cause, this is not a general reason (indication) for the administration of antibiotics. What is decisive is which symptoms are present, to what extent and which types of pathogens are present. The doctor then decides whether and which antibiotic to take.

Since 2020, the attending physician will consider COVID-19 disease as a possible cause (differential diagnosis) for every new respiratory disease. This is especially true if symptoms typical of COVID-19 such as cough, fever, shortness of breath, sore throat and sudden loss of smell and taste occur. Then an additional diagnosis must be initiated by the doctor.

Course of the disease and prognosis

As a rule, a lateral strand angina does not last long. The symptoms subside after three to six days at the latest.

In individual cases, the general state of health of the person affected determines the course of the disease. Duration and therapy are extended, for example, if other diseases are present or the immune system is weakened. Complications are also possible, such as a sudden increase in fever and severe pain.

A tympanic effusion, a middle ear infection (otitis media) and accumulations of pus (abscesses) in the area of ​​​​​​the palate or throat sometimes occur.

Other complications and possible sequelae of an untreated lateral angina are rheumatic fever, kidney inflammation or inflammation of the heart muscle (myocarditis) and the heart membranes (endo- and pericarditis).

In very rare cases, the pathogen penetrates the bloodstream and triggers blood poisoning (sepsis). A stay in the hospital is then necessary.

In most cases, complications of lateral angina can be avoided by starting treatment early, and those affected recover within a few days. Even a chronic side strand angina sometimes heals completely if the cause of the disease is eliminated and consistent therapy is carried out.

Are there preventive measures?

In general, sore throats and also the lateral angina occur most frequently in the cold season, ie during the classic cold season.

Measures that strengthen the body’s defenses help preventively. This includes, for example, a healthy diet with plenty of vitamins, drinking plenty of fluids and exercise in the fresh air. In addition, hardening through the sauna and alternating showers is recommended.

It helps those affected with chronic sore throat to eliminate or at least avoid the triggering stimulus, such as smoking or excessive alcohol consumption.

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