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Angina pectoris
- 1. ANGINA PECTORIS BY KAMOLIKA DOCTOROF PHARMACY ( 2YR) TEERTHANKER MAHAVIR UNIVERSITY
- 2. STRANGLING CHEST STRANGLING INTHE CHEST PECTORIS ANGINA ANGINA PECTORIS
- 3. ANGINA PECTORIS • Anginapectoris 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 .
- 4. TYPES OF ANGINA •STABLE ANGINA • UNSTABLE ANGINA • PRINZMETAL’S ANGINA
- 5. STABLE ANGINA /FIXEDSTENOSIS/ 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
- 7. UNSTABLE ANGINA(THROMBUS) • Causedby 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.
- 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 RISKFACTORS • 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 • STRESSTEST • CARDIAC CATHETERIZATION • CARDIAC MRI • CORONARY MRI • CORONARY CT SCAN • ANGIOGRAPHY • SERIAL CARDIAC BIOMARKER TEST
- 14. COMPLICATIONS HEART ATTACK • Mostcases 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
- 15. TREATMENT • NITROGLYCERIN • B–BLOCKER • CALCIUM CHANNEL BLOCKER • ANTIPLATELET THERAPY –ASPIRIN , CLOPIDOGRAL • ANTIANGINAL DRUG THERAPY – GLYCERYL TRINITRATES , ISOSORBIDE MONONITRATE ,ISOSORBIDE DINITRATE • POTASSIUM CHANNEL ACTIVATOR – NICORANDIL • SURGICAL • CABG- coronary artery bypass grafting • PCI- percutaneous coronary intervention • PTCA – percutaneous transmural coronary angioplasty