Which of the following can trigger angina symptoms?

Angina symptoms are primarily associated with a lack of oxygen to the heart, often due to narrowed coronary arteries. Physical exertion and emotional stress are significant triggers because they increase the heart's demand for oxygen. When an individual exerts themselves physically, such as during exercise, or experiences stress, the heart beats faster and works harder, leading to a greater oxygen requirement. If the coronary arteries cannot supply enough oxygen-rich blood to meet this demand, it can result in angina symptoms.

While other factors like sleep and high temperatures can influence heart health, they do not typically provoke angina in the same direct manner as exertion and stress. Visual stimuli are also generally less specific in causing angina unless they provoke stress or anxiety. Thus, exertion and stress are the primary triggers that lead to angina symptoms due to the increased workload they impose on the heart.