This document defines angina pectoris as recurring chest pain or discomfort caused by decreased blood flow to the heart. It describes the general symptoms of angina and the three main types: stable angina induced by physical activity and relieved by rest, unstable angina which occurs more frequently and can lead to heart attack, and Prinzmetal's angina which occurs at rest due to coronary artery spasm. The case presented is determined to be stable angina based on the chest tightness occurring during physical activity and disappearing with rest.

1. Ali Al-Nasrullah
Angina Pectoris

2. Learning Objectives
• Definition of angina.
• General symptoms of angina.
• Types of angina.
• 1 Question about the case

3. Angina Pectoris
• is recurring acute chest pain or discomfort resulting
from decreased blood supply to the heart muscle
(myocardial ischemia).
• “Increasing Demand of oxygen but the heart can’t
supply”
• Generally due to obstruction or spasm of the
coronary arteries.
• The chest pain comes either as a form of pressure or
discomfort

6. General Symptoms
• Severe chest discomfort (heaviness, pressure, tightness, choking,
squeezing)
• The pain may radiate to the shoulders, arms, back,
neck, or jaw.
• Palpitations
• Sweating
• Dizziness
• Dyspnea

8. Types
• Angina is consisted of three types:
• Stable
• Unstable
• Variant (Prinzmetal's Angina)

9. Stable Angina
• Most common type
• Induced by physical activity (increase demand of
O2), or emotional stress.
• And can’t be supplied because of partially
occluded coronary artery caused by
atherosclerosis)
• The pain is relieved by rest.

11. Unstable Angina
• Dangerous and requires emergency treatment.
It is the rupture of the fibrous cap, leading to the blockage of
the artery by clotted blood.
• Occurs with increasing frequency (progression)
• Affects the patient's life by not being able to
work.
• Low response to therapy and could lead to MI.

13. Prinzmetal's Angina
Usually affects arteries already narrowed by atherosclerosis
•Occurs when a person is at rest or sleep
•The pain is induced from the spasm of the coronary artery.
Thereby when the coronary artery is going to spasms it
narrows the artery thus lowering the amount of blood to the
heart.
•The pain is fluctuated during the day (come and goes)

15. The Case
• The patient’s pain is:
• 1- Tight feeling on the chest (Angina)
• 2- During walking or cycling (physical activity)
• 3-Disappears in rest
•
What type of angina is this ?

16. Answer
Stable Angina