Which factor is commonly associated with stable angina?

Stable angina is characterized by predictable episodes of chest pain or discomfort that typically occur during physical exertion or in response to specific triggers, such as emotional stress or environmental conditions like cold weather. This pattern reflects the underlying mechanism of stable angina, which is primarily due to fixed atherosclerotic coronary artery disease that limits blood flow during times of increased demand.

When engaging in physical activity or facing environmental stressors, the heart requires more oxygen, but the narrowed coronary arteries cannot supply sufficient blood to meet this demand, leading to the characteristic chest pain. Therefore, the relationship to overexertion and certain environmental conditions is a hallmark of stable angina, making it the correct choice.

The other factors, such as occurring without physical exertion or being caused by vasospasm, are more indicative of unstable angina or variant angina, which do not follow the predictable pattern seen in stable angina. Being felt during sleep may also indicate different types of angina episodes, such as nocturnal angina, which are not characteristic of stable angina either.