Angina Pain and Related Cardiovascular Problems

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Angina Pain and Related Cardiovascular Problems

  1. 1. Angina Pain and Related Cardiovascular Problems <ul><li>Ric and Jennifer </li></ul>
  2. 2. What is Angina Pain? <ul><li>A condition often referred to as </li></ul><ul><li>“angina pectoris” --refers to thoracic pain originating from a lack of oxygen to the heart muscle (ischemia) </li></ul><ul><li>Described by a feeling of discomfort or heavy pressure localized in the chest region </li></ul>
  3. 3. How it differs from a Heart Attack… <ul><li>Angina pain is a short pain resulting from the muscle temporarily receiving insufficient amounts of oxygen </li></ul><ul><li>vs. </li></ul><ul><li>Myocardium infarction results in cardiac arrest and permanent damage to the heart muscle, results from a complete cut off of oxygen </li></ul>
  4. 4. Types of Angina <ul><li>1.) Angina of Effort- A medical condition that often results from atherosclerosis </li></ul><ul><li>- arteries can supply sufficient oxygen to resting heart but fail to do so during periods of exercise or stress resulting in a painful sensation </li></ul><ul><li>2.) Variant Angina- An uncommon condition that exists independently of atherosclerosis </li></ul><ul><li>-arteries cannot supply enough oxygen to the resting heart; the condition does not result from excessive work by myocardium </li></ul><ul><li>*can also occur as a result of eating (postprandial) and while sleeping (nocturnal) </li></ul>
  5. 5. Symptoms of Angina <ul><li>Pain/heaviness under the sternum </li></ul><ul><li>Can be experienced elsewhere (back, arms, neck, shoulders, or jaw regions) </li></ul><ul><li>Breathlessness and Fatigue </li></ul><ul><li>Increased risk of heart attack </li></ul>
  6. 6. Causes of Angina <ul><li>Excessive exercise and stress when coupled with atherosclerosis (effort) </li></ul><ul><li>Insufficient coronary arterial muscle spasms (variant) </li></ul><ul><li>The difference between demand and supply of blood/oxygen to myocardium </li></ul><ul><li>---5% of angina cases actually result from a predisposed heart demanding an abnormal amount of oxygen to function </li></ul><ul><li>*more common in the adult population as risk for coronary heart disease increases </li></ul>
  7. 7. Detection Methods <ul><li>Physicians </li></ul><ul><li>Electrocardiogram –non-invasive (85% accurate) </li></ul><ul><li>Stress Tests </li></ul><ul><li>Angiograms –invasive (used in other 15% of cases) </li></ul>
  8. 8. Electrocardiogram <ul><li>Electrocardiogram*- useful to confirm Angina pain and other abnormal features </li></ul><ul><li>-must be coupled with some sort of stress test (before, during, and after) </li></ul><ul><li>Echocardiogam- associates symptoms and ECG levels during a 24 hour period </li></ul><ul><li>(used with nocturnal angina) </li></ul>
  9. 9. Angiogram <ul><li>a virtual x-ray of coronary arteries </li></ul><ul><li>Image is derived by the placement of a catheter in a major coronary artery </li></ul><ul><li>Dye is injected to “see” the blood flow to the heart </li></ul><ul><li>*Most accurate and effective way to determine presence and severity of angina </li></ul>
  10. 10. Risk Factors <ul><li>Cigarette Smoking (results in atheroma) </li></ul><ul><li>High cholesterol intake (results in atheroma) </li></ul><ul><li>Extreme temperatures </li></ul><ul><li>Emotional Stress </li></ul><ul><li>Alcohol Abuse </li></ul><ul><li>Heredity …ethnic predispositions/diabetes </li></ul><ul><li>Personality Type </li></ul>
  11. 11. Treatments <ul><li>Often can be alleviated within minutes by relaxation/resting </li></ul><ul><li>Intake of prescribed angina medications often consisting of nitroglycerin (reduces ischemia) </li></ul><ul><li>Reduce risk factors through conventional treatments </li></ul><ul><li>Surgical procedures increase blood flow to the heart </li></ul>
  12. 12. Conventional Treatments <ul><li>Exercise/yoga and even massage therapy have been said to alleviate painful effects </li></ul><ul><li>Behavioral counseling-reduce cholesterol, smoking, drinking, and obesity (i.e.- diet) </li></ul><ul><li>Nitroglycerin meds.- increases diameter of blood vessels (taken orally or transdermally) </li></ul><ul><li>Beta blockers- decrease demand and workload of myocardium </li></ul>
  13. 13. Surgical Treatments <ul><li>Coronary Bypass Surgery- blood vessel from leg often grafted on the blocked artery, increasing blood flow </li></ul><ul><li>Balloon angioplasty- catheter with small balloon placed into coronary artery to expand blood vessel </li></ul><ul><li>Angioplasty and bypass surgery often followed by behavioral counseling to reduce risk factors like obesity </li></ul>
  14. 14. Final Thought <ul><li>*We must take preventative efforts to help reduce the presence of Coronary Artery Disease, as it is the underlying cause of angina pain * </li></ul>
  15. 15. Road Map <ul><li>Coronary Heart Disease </li></ul><ul><ul><li>What is it? </li></ul></ul><ul><li>Risk Factors </li></ul><ul><ul><li>Unavoidable </li></ul></ul><ul><ul><li>Treatable or changeable </li></ul></ul><ul><li>Myocardial Infarctions </li></ul><ul><ul><li>What is it? </li></ul></ul><ul><ul><li>Symptoms </li></ul></ul><ul><ul><li>Treatment options </li></ul></ul>
  16. 16. What is Heart Disease? <ul><li>Called Coronary Heart Disease or Coronary Artery Disease </li></ul><ul><li>Diagnosed when arteries that supply blood to heart muscle becomes hardened and narrowed </li></ul><ul><ul><li>Caused by plaque on inner walls and called atherosclerosis </li></ul></ul><ul><ul><li>Eventually Heart suffers from lack of oxygen and causes </li></ul></ul><ul><ul><ul><li>Angina </li></ul></ul></ul><ul><ul><ul><li>Heart Attack (Myocardial infarction) </li></ul></ul></ul>
  17. 17. Clogged arteries
  18. 18. Who can develop Heart Disease? <ul><li>Unavoidable Risk Factors </li></ul><ul><ul><li>Age </li></ul></ul><ul><ul><li>Sex </li></ul></ul><ul><ul><li>Heredity </li></ul></ul><ul><li>Treatable Risk Factors </li></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>High Blood Pressure </li></ul></ul><ul><ul><li>High Blood Cholesterol </li></ul></ul><ul><ul><li>Physical Activity </li></ul></ul><ul><ul><li>Obesity </li></ul></ul><ul><ul><li>Diabetes </li></ul></ul>
  19. 19. Unavoidable Risk Factors <ul><li>Increasing Age – Fact of life, everyone gets older. 83 % of people who die from Heart Disease is over 65 </li></ul><ul><li>Being male – Have a greater risk and die younger </li></ul><ul><li>Heredity -- Children with parents suffering from Heart Disease; African Americans greater risk of High Blood Pressure and Heart Disease </li></ul>
  20. 20. Risk Factors that can be changed or treated <ul><li>Smoking – Smokers have increased risk 2-4 times greater than non-smokers </li></ul><ul><li>High Blood Cholesterol – The greater amount of cholesterol greater increase risk of heart disease </li></ul><ul><li>High Blood Pressure – Greater the pressure, the harder the heart must work, causing heart to thicken and stiffer </li></ul>
  21. 21. Treatable Risk Factors (cont) <ul><li>Physical Inactivity – inactive lifestyle increases risk of heart disease; regular moderate-to-vigorous physical activity helps prevent heart and blood vessel disease </li></ul><ul><li>Obesity and overweight – people with excess body fat are more likely to develop heart disease and strokes </li></ul><ul><li>Diabetes mellitus – Even when glucose levels are under control, there is still an increased risk, but risk is greater if left untreated </li></ul>
  22. 22. Predicting who will develop heart disease <ul><li>Subjects: 2489 men and 2856 women 30 to 74 yrs. Old </li></ul><ul><ul><li>Baseline reading </li></ul></ul><ul><ul><li>12 years later </li></ul></ul><ul><ul><ul><li>Subjects 383 men and 227 women developed heart disease </li></ul></ul></ul><ul><ul><ul><li>Those with heart disease were associated with high blood pressure, total cholesterol, LDL and HDL, sex, </li></ul></ul></ul><ul><ul><ul><li>Used prediction equation to predict likelihood of developing disease </li></ul></ul></ul><ul><ul><ul><ul><li>Age, diabetes, smoking, blood pressure, total cholesterol, and LDL </li></ul></ul></ul></ul>
  23. 23. Results And Discussion <ul><li>28 % of male and 29 % female cases attributed to blood pressure levels that exceeded normal high130/85 </li></ul><ul><li>27 % of male and 34 % female cases attributed to high total cholesterol (greater than 200 mg/dL) </li></ul><ul><li>Study confirmed the medical guidelines for blood pressure, total Cholesterol, and LDL as accurate for predicting risk of middle-aged white population </li></ul>
  24. 24. Myocardial Infarctions <ul><li>Also known as an MI or heart attack </li></ul><ul><li>Happens when the blood supply to the heart is blocked long enough to cause death of heart tissues </li></ul><ul><li>If enough permanent damage occurs, the patient may die </li></ul>
  25. 25. Myocardial Infarction
  26. 26. Symptoms of MI <ul><li>Angina </li></ul><ul><li>Pain or discomfort in upper arms, left shoulder, back, neck, jaw or stomach </li></ul><ul><li>Difficulty Breathing </li></ul><ul><li>Sweating or “cold sweat” </li></ul><ul><li>Fullness, indigestion, or heartburn </li></ul><ul><li>Feeling Lightheaded </li></ul><ul><li>Extreme weakness </li></ul><ul><li>Rapid, irregular heart rate </li></ul>
  27. 27. Treatment Options <ul><li>Before getting to the hospital </li></ul><ul><ul><li>Quick response time is critical </li></ul></ul><ul><ul><li>Call 911 if observe symptoms and do CPR if necessary </li></ul></ul><ul><ul><li>Can take asprin, heprin, antiplatelet drugs, therombic therapy </li></ul></ul><ul><li>At the hospital </li></ul><ul><ul><li>Angioplasty </li></ul></ul><ul><ul><li>Bypass surgery </li></ul></ul>
  28. 28. References <ul><li>Larson, J.P. (2006) Angina. Encyclopedia of Medicine . </li></ul><ul><li>Satyamurthy, I. & Sharma, V. (2004). What is Angina? DoctorNDTV, Aug. 13. </li></ul><ul><li><http://www.americanheart.org> </li></ul><ul><li>Peter W. F., Wilson MD, Ralph B. ,D’Agostino PhD, Levy MD, Belanger BS, Sibershatz PhD, Kannel MD. (1998). Prediction of Coronary Heart Disease Using Risk Factor Categories. Circulation 97, 1837-1847. Retrieved November 6, 2006 from http://circ.ahajournals.org/cgi/reprint/97/18/1837.pdf . </li></ul><ul><li>http:// en.wikipedia.org/wiki/Myocardial_infarction </li></ul><ul><li>http://www.clevelandclinic.org/heartcenter/pub/guide/disease/cad/mi_symptoms.htm </li></ul>

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