A discussion on Angina Pectoris by Dr Christa Maria Joel MBBS MPH

1. Angina Pectoris

2. What is angina and
its symptoms?

3. Precipitating
factors

4. New York Heart Association (NYHA) functional classification of
angina
Unaccustomed
work can
produce
symptoms
01
Ordinary
activity can
produce
symptoms
02
Routine
activities
produce
symptoms.
03
Symptoms at
rest.
04

5. Diagnosis
ECG- to check for
arrhythmias and
heart blocks.
Treadmill test/
TMT/ exercise
stress ECG- for
ischemic changes.
Blood work: fasting
lipid profile, blood
glucose levels.
Echocardiogram: to
check for ejection
fraction.
X-ray: to check for
cardiac failure and
valvular disease.
Coronary
angiography- to
check the coronary
blood vessels.

6. Treatment
Bed rest Oxygen
2mg IV
morphine with
IV
metoclopramid
e 10 mg.
Sublingual
nitrates-
Sorbitrate
5mg
Nitroglycerin
e infusion-
5mcg/min
Antiplatelets
like aspirin
300mg
followed by
aspirin 150
mg/day daily;
clopidogrel
300mg stat
followed by 75
mg/day;
platelets
glycoprotein
IIb/ IIIa
antagonists
like Abciximab
and
Eptifibatide.
Beta-
blockers like
metoprolol
Calcium channel blocker-
diltiazem, nifedipine,
verapamil, amlodipine.
ACE inhibitor-
ramipril
Nicorandil
(potassium
channel
activator)
Statins to lower
cholesterol-
atorvastatin Antithrombins-
LMWH
Angioplasty or
coronary artery
bypass grafting.

7. Thank you