is chest pain or discomfort caused when your
heart muscle doesn't get enough oxygen-rich
blood. It may feel like pressure or squeezing in
your chest. The discomfort also can occur in
your shoulders, arms, neck, jaw, or back. Angina
pain may even feel like indigestion.
Pathogeneses of
angina
Types
stable angina
variant angina
Unstable angina
is characterized by increasingly frequent pain, precipitated by progressively less exertion or
even occurring at rest.
occurs at rest and is caused by coronary artery spasm
is predictable episodic chest pain associated with particular levels of exertion or some other
increased demand (
Risk factors
Age Family history of premature
coronary artery disease or stroke
Lipid abnormalities Smoking
tobacco , hypertension, diabetes
mellitus Subtract 1 from the total
number o f risk factors if HDL> 60
mg/dL.
Emergency
Morphine
Oxygen [2]
Nitrate
Aspirin
Pharmacological
Atenolol (50mg)
used alone or in combination with other medications
to treat high blood pressure.
B-Blocker - relaxing blood vessels and slowing heart rate to improve blood
flow and decrease blood pressure
Side effects
shortness of breath swelling of the
hands, feet, ankles, or lower legs
weight gain fainting Drowsiness and
tiredness depression
Orally taken - One tablet daily
Isosorbide dinitrate (10mg)
is used to prevent angina (chest pain) caused
by coronary artery disease.
not work fast enough to relieve the pain of an angina
attack that has already started.
dinitrate belongs to the group of medicines called nitrates.
When used regularly on a long-term basis, this helps prevent
angina attacks from occurring.
Aspirin (150mg)
used to prevent heart attacks in people who have had a heart
attack in the past or who have angina
used to reduce the risk of death in people who are
experiencing or who have recently experienced a heart
attack.
side effect
Nausea, vomiting stomach pain,
heartburn Hives and rash
swelling of the eyes, face, lips,
tongue, or throat wheezing or
difficulty breathing
It works by stopping the production of certain
natural substances that cause fever, pain, swelling,
and blood clots.
Glyceryl trinitrate (GTN)
sublingual tablets are used to treat episodes of angina (chest
pain) in people who have coronary artery disease.
used just before activities that may cause
episodes of angina in order to prevent the
angina from occurring.
Nitroglycerin is in a class of
medications called vasodilators.
side effect
dry mouth rash, blistering, or
peeling of the skin Hives, itching
difficulty breathing or
swallowing Nausea, vomiting
It works by relaxing the blood vessels so the
heart does not need to work as hard and
therefore does not need as much oxygen.
Myocardial infarction
Types
s&s
Microscopic features
Complications-
ventricular
tachycardia
s a type of regular and fast heart
rate that arises from improper
electrical activity in the ventricles of
the heart.
shock
Risk factors
Age Smoking High BP High
cholesterol or triglycerides
level (LDL) Diabetes Family
history Lack of physical
activity Obesity stress Illegal
drug use A history of
preeclampsia History of
autoimmune condition
(rheumatoid arthritis or lupus)
Treatment of mi-
surgical
Coronary
angioplasty
is a procedure used to open clogged heart
arteries. Angioplasty involves temporarily
inserting and inflating a tiny balloon where
your artery is clogged to help widen the
artery
Complications include (Red
flags):
Signs of infection, such as redness,
swelling, drainage or fever There's
a change in temperature or color
of the leg or arm that was used for
the procedure You feel faint or
weak You develop chest pain or
shortness of breath
Investigations
ECG
Lipid profile
Chest x-ray
Blood
tests
Echocardiogram
Coronary
angiography
Biomarkers:
CK Ck-MB
C-Troponin I
Lactate
dehydrogenase
Myoglobin