Angina pectoris is chest pain due to insufficient blood flow, often caused by conditions like atherosclerosis and is a warning sign for heart attack or cardiac events. It presents in various forms, including stable, unstable, and variant angina, with symptoms that may differ between individuals, particularly between genders. Management includes lifestyle changes, medications, and potential surgical interventions to restore blood supply and mitigate risk factors.

2.  Angina pectoris is the
medical term for chest
pain or discomfort
 Cause:insufficient
blood flow
 Angina is a symptom
of a condition called
myocardial ischemia
 Artherosclerosis,
Coronary artery
disease are the main
causes of angina

3. ATHEROSCLEROSIS
CORONARY ARTERY DISEASE
ISCHEMIA INFARCTION
ANGINA MI
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7.  Angina is a sign that someone is at
increased risk of heart attack, cardiac
arrest and sudden cardiac death.
 It may occur in the absence of a significant
disease of the coronary arteries as a result
of coronary spasm, stenosis or insufficiency
and etc.

8. There is a weak relationship between pain and
oxygen deprivation in the heart muscle
TRUE!!!!!
“there can be severe pain with little or no
risk of a heart attack, and a heart attack
can occur without pain”

10. 2.Unstable angina
1. Stable angina  preinfarction angina
 symptoms occur frequently
 chronic stable and last longer
angina  pain is lower, and may occur
at rest
 have episodes of
 It has at least one of these
chest discomfort three features:
that are usually  usually lasting >10 min;
predictable  it is severe and of new onset
 They occur on (i.e., within the prior 4–6
weeks); and/or
exertion or stress.  it occurs with a crescendo
pattern (i.e., distinctly more
severe, prolonged, or frequent
than previously).
 are not relieved by rest and
NGT tab.

12. 3. Intractable or refractory angina
 severe incapacitating chest pain
4. Variant angina
 also called Prinzmetal’s angina
 pain at rest with reversible ST-segment elevation
 It usually occurs spontaneously
 it nearly always occurs when a person is at rest.
 It doesn't follow physical exertion or emotional stress,
either.
 Attacks can be very painful and usually occur between
midnight and 8 a.m
5. Silent ishemia
 objective evidence of ishemia(such as ECG changes with
a stress test), but patient reports no symptoms.

13.  cigarette smoking
 diabetes
 high cholesterol
 high blood pressure
 sedentary lifestyle
 family hx. of premature heart disease
 Kidney disease

14.  may produce pain varying in severity from mild
indigestion to a choking ► heavy sensation in the upper
chest that ranges from discomfort to agonizing pain
 accompanied by severe apprehension and a feeling of
impending death
 The patient with DM may not experience pain
 The pain is retrosternal
 the pain is poorly localized and may radiate to the neck,
jaw, and shoulders, and inner aspects of the upper
arms, usually the left arm.

15.  woman may have different symptoms than man
 weakness or numbness in the arms, wrists and
hands, as well SOB, pallor, diaphoresis,
dizziness or lightheadedness and nausea and
vomiting may accompany the pain
 atypical symptoms, including breathlessness,
nausea, or epigastric discomfort or burping.
(women)
 It is exacerbated by having a full stomach and
by cold temperatures
 it subsides with rest or nitroglycerin

16. Suspect angina:
 people presenting with tight, dull, or heavy
chest discomfort :
 Retrosternal or left-sided
 radiating to the left arm, neck, jaw, or back
 Associated with exertion or emotional stress
and relieved within several minutes by rest
 Precipitated by cold weather or a meal.

17.  ECG
 STRESS TESTING
 ECHOCARDIOGRAM
 CORONARY ANGIOGRAM
 C-reactive Protein

19.  Elderly persons with angina may not exhibit
the typical pain profile because of the
diminished responses of neurotransmitters
that occur with aging, often the presenting
symptoms in the elderly is dyspnea. If pain
occurs it radiates to both arm not only in left
arm, some times there is no symptoms

20.  OXYGEN DEMAND OXYGEN
SUPPLY
 are met through pharmacologic therapy and
control of risk factors
 Reperfusion procedures may be used to
restore the blood supply to the myocardium.
 These includes PCI
procedures(percutaneous transluminal
coronary angioplasty [PTCA], intracoronary
stents and atherectomy and CABG

21.  Stop smoking
 Cut down on fatty foods, especially high fat foods if
you have high blood cholesterol levels
 Increase your level of exercise
 Eat more oats, which have been shown to reduce
cholesterol
 Lose weight if your doctor thinks you are
overweight
 Make sure your blood pressure is not high by
having regular check ups
 Consider another method of contraception if you
take the Pill

22.  Percutaneous transluminal coronary
angioplasty
 Intracoronary Stents
 CABG (Coronary Artery bypass
surgery)

23.  Nitroglycerin
Ex. Drugs (Nitrostat, Nitrol, Nitro-Bid)
 Beta-Adrenergic Blocking Agents
Ex. Drugs (Lopressor, Toprol, atenolol)
Calcium Channel Blockers
Ex. Drugs (Norvasc, Cardizem, Tiazac)

24.  Antiplatelet
and Anticoagulant
Ex. Drugs ( Aspirin, Clodogrel,
Heparin)
 Oxygen Administration

25.  stop all activities
 sit or rest in a bed in a semi-Fowler’s
 alternate rest and activity periods.
 Assess pain and vital signs, noting respiratory
distress, ans ST segment on ECG.
 Administer nitroglycerin(up to 3 doses) and
oxygen.
 stress reduction methods with patient(eg, music
therapy)

26.  Stop smoking
 Cut down on fatty foods, especially high fat
foods if you have high blood cholesterol
levels
 Eat more oats, which have been shown to
reduce cholesterol
 Lose weight if your doctor thinks you are
overweight
 Make sure your blood pressure is not high by
having regular check ups