Angina is chest pain caused by reduced blood flow to the heart muscles. It's not usually life threatening, but it's a warning sign that you could be at risk of a heart attack or stroke. With treatment and healthy lifestyle changes, it's possible to control angina and reduce the risk of these more serious problems.

1. ANGINA PECTORIS
Angina pectoris is severe chest pain due to
ischemia (a lack of blood and hence oxygen
supply) of the heart muscle, generally due to
obstruction or spasm of the coronary arteries.
Coronary artery disease,
the main cause of angina,
is due to atherosclerosis
of the cardiac arteries.

2.  SIGN AND SYMPTOMS.
 Angina pectoris can be quite painful,
but many patients with angina
complain of chest discomfort rather
than actual pain: the discomfort is
usually described as a pressure,
heaviness, tightness, squeezing,
burning, or choking sensation. Pain in
back, neck area, jaw, or shoulders Etc.
ANGINA PECTORIS

3.  OTHER SYMPTOMS OF ANGINA
ARE
 A feeling of indigestion or heartburn
 Dizziness
 Nausea, vomiting and sweating
 Palpitation
ANGINA PECTORIS

4.  Major risk factors
 Age (Above 55 years in men, above 65 years in women)
 Cigarette smoking
 Diabetes mellitus (DM)
 Dyslipidemia
 Family history of
premature cardiovascular disease
 Age(men below 55 years, female below 65 years old)
 Hypertension
 Physical inactivity

ANGINA PECTORIS

5. ANGINA PECTORIS
THREE TYPES OF ANGINA
•1,STABLE ANGINA
•Stable angina is that of chest discomfort and
associated symptoms precipitated by some activity
(running, walking, etc.) also known as Effort angina
•2,UN STABLE ANGINA
• This is a form of acute coronary syndrome)occurs at
rest (or with minimal exertion), usually lasting >10 min;
and also known as "crescendo angina;"

6.  PRINZMETAL ANGINA.
 It is also known as variant angina, or angina
inversa, is a syndrome typically consisting
of angina(cardiac chest pain) at rest that
occurs in cycles. It is caused by vasospasm, a
narrowing of the coronary arteries caused by
contraction of the smooth muscle tissue in the
vessel walls rather than directly
by atherosclerosis . It occurs more in younger
women in between midnight and morning.
ANGINA PECTORIS

7. ANGINA PECTORIS
 OTHER CAUSES OF ANGINA.
 Abnormal heart rhythms
 Anemia
 Coronary artery spasm(prinzmetal)
 Heart failure
 Heart valve disease
 Hyperthyroidism

8. ANGINA PECTORIS
DIAGNOSIS
•Electrocardiogram (ECG)
•Exercise ECG test ("treadmill
test")
•Thallium scintigram
•Stress Echocardiography
•Coronary angiogram

9. ANGINA PECTORIS
TREATMENT
General measures
•Smoking cessation
•Treat risk factors, including hypertension,
diabetes mellitus, obesity, and hyperlipidemia.

10. ANGINA PECTORIS
TREATMENTS
•Antiplatelet agents
•Beta-adrenergic blocking agents
•Like cardiolite
•Calcium channel blockers
•Nitroglycerins
Angiotensin-converting enzyme inhibitors

11. ANGINA PECTORIS
FORTHETREATMENTOF ANGINAPECTORISOR
ISCHEMICHEARTDISEASEDOCTOR’SFIRST
CHOICEIS BETABLOCKERLIKEATENOLOL,
BISOPROLOL,NEBIVOLOLAND
PROPARONOLOL.

12. ANGINA PECTORIS
CARDIOLITE
Cardiolite is a beta1-selective
(cardioselective)
beta-adrenergic receptor blocking agent.

13. MECHANISMS OF ACTION:
 Competitive antagonism of catecholamines
at peripheral (especially cardiac) adrenergic
neuron sites.
 A central effect leading to reduced
sympathetic outflow to the periphery.
 Suppression of renin activity.
ANGINA PECTORIS

14. PHARMACOKINETICS:
Absorption: 50%
First Pass Metabolism: Little or no
Bioavailability: 45 – 55%
Peak plasma level: 2 – 4 hrs.
Half Life: 6 – 8hrs.
Active Metabolites: None
Elimination: renal
ANGINA PECTORIS