3. ANGINA PECTORIS
• Angina pectoris is a temporary , substernal chest pain occurring due
to imbalance between myocardial oxygen supply and demand .
or
• A disease market by sudden attack of chest pain or discomfort caused
by deficient oxygenation of heart muscle usually due to impaired
blood flow to the heart .
5. STABLE ANGINA /FIXED STENOSIS/ DEMAND ISCHEMIA
Stable angina is the most common.
• Chronic narrowing of coronary arteries due to atherosclerosis
• Tissue become ischemic particularly during times of increaded oxygen
demand
• Physical stress can trigger it
• It usually lasts a few minutes and goes away after rest
• Stable angina is not heart attack , but it suggest that a heart attack is more
likely to happen in future.
• CHARACTERISTICS OF STABLE ANGINA
• Develops during exercise or climb stairs
• Lasts a short time, perhaps five minutes or less
• The severity , duration and type of angina can vary.
• Relieved by rest or medication
6.
7. UNSTABLE ANGINA(THROMBUS)
• Caused by formation and dissolution of a blood clot (thrombus)
within a coronary artery
• It may occur more often and be more severe than stable angina
• This usually occur when person is at resting position
• Sudden pain
• The pain can be strong and long-lasting ,
• Not relieved by nitroglycerin
• Unstable angina is very dangerous and required emergency treatment
• This type of angina is sign that a heart attack may happen soon.
8.
9. PRINZMETAL’S ANGINA ( VARIANT ANGINA)
• Variant angina is rare
• Results from coronary vasospasm ,which temporarily reduced
coronary blood flow
• Emotional stress , dysfunctional coronary vascular endothelium
occurs during night rest.
• A spasm in a coronary artery causes this type of angina
• Narrow artery reduce blood flow to heart , causing chest pain.
• Emotional stress , smoking and use of the illegal drug coccain may
trigger this type of angina
• It is usually happen between midnight and early morning
• Medicine can relive this type of angina
10. CAUSES AND RISK FACTORS
• High blood pressure
• Atherosclerosis
• Blocked artery
• Coronary artery spasm
• Microvascular constriction
• High blood cholesterol or triglyceride
• Excess intake of fat or salt
• Smoking
• Diabetes mellitus
• Obesity
• Metabolic syndrome
• Sedentary life style or overwork
• Older age (men after 45 and women after 55)
• Family history of early heart disease
11. PATHOPHYSIOLOGY :-
VASOSPASM,FIXED STENOSIS, CORONARY THROMBOSIS
INSUFFICIENT CORONARY BLOOD FLOW
DECREADED OXYGEN SUPPLY TO MEET AN INCREASED
MYOCARDIAL CELL FOR OXYGEN
NEED OF OXYGEN EXCEEDS THE SUPPLY
DECREASED OXYGEN SUPPLY /DEMAND RATIO
MYOCAEDIAL HYPOXIA
STIMULATION OF PAIN RECEPTOR WITHIN MYOCARDIUM
ANGINA PECTORIS
12. SIGNS AND SYMPTOMS
• Angina is usually felt in the chest region as;
• Squeezing
• Pressure
• Heaviness
• Tightening
• This pain often spreads to the neck , jaw, arms , shoulders , throat , back , or even the teeth.
• OTHERS SYMPTOMS
• Indigestion
• Heartburn
• Weakness
• Sweating
• Nausea
• Cramping
• Shortness of breath
13. DIAGNOSIS
• ELECTROCARDIOGRAM
• STRESS TEST
• CARDIAC CATHETERIZATION
• CARDIAC MRI
• CORONARY MRI
• CORONARY CT SCAN
• ANGIOGRAPHY
• SERIAL CARDIAC BIOMARKER TEST
14. COMPLICATIONS
HEART ATTACK
• Most cases of angina are caused by fatty deposits.
• Plague breaks causing a blood then block the supply of oxygen – rich blood to the muscles of the
heart , causing extensive damage to the heat muscles and triggering a heart attack
STROKE
• The second common complication of angina
• Reduced blood flow to brain
FAST PARAMETER
• FACE-one side dropped face, no smile , drooped eye and mouth
• ARMS- arm weakness or numbness
• SPEECH- slurred or garbled speech
• TIME- should to taken care at the earliest
STRESS, ANXIETY AND DEPRESSION
• Psychological facts which often felt down, depressed or hopeless
• Found little interest or pleasure in doing things
