ANGINA PECTORIS

 Angina is a type of chest pain caused by reduced blood flow to the heart. Angina
is a symptom of coronary disease.
 Angina, which may also be called angina pectoris, is often described as
squeezing, pressure, heaviness, tightness or pain in your chest.
 Some people with angina symptoms describe angina as a feeling like a vise is
squeezing their chest or feeling like a heavy weight has been placed on their
chest.

CAUSES

 Angina is caused by reduced blood flow to your heart muscle. Your blood carries
oxygen; it causes a condition called ischemia.
 The most common cause of reduced blood flow to your heart muscle is coronary
artery disease (CAD). Your heart arteries can become narrowed by fatty deposits
called plaques. This is called atherosclerosis.
 This reduced blood flow is a supply problem – your heart is not getting enough
oxygen-rich blood. You may wonder why you don’t always have angina if your
heart arteries are narrowed due to fatty buildup.
 This is because times of low oxygen demand – when you’re resting, for example
– your heart muscle may be able to get by on the reduced amount of blood flow
without triggering angina symptoms. But when you increase the demand, such as
when you exercise, this can cause angina.

TYPES OF ANGINA

1. STABLE ANGINA / ANGINA PECTORIS

 Develops when your heart works harder, such as when you exercise or climb
stairs
 Can usually be predicted and the pain is usually similar to previous types of chest
pain you’ve had.
 Lasts a short time, perhaps five minutes or less
 Disappears sooner if you rest or use your angina medication

1. UNSTABLE ANGINA
 Occurs even at rest
 Is a change of usual pattern of angina
 Is unexpected
 Is usually more severe and lasts longer than stable angina, maybe 30 minutes or
longer
  May not disappear with rest or use of angina medications.
 Might signal a heart attack

2. VARIANT (PRINZMETAL) ANGINA

 This type of angina is rarer. It is caused by spasm in your heart’s arteries that
temporarily reduces blood flow
 Usually happens when you are resting
 Is often severe
 May be relieved by angina medication
 Emotional stress, smoking and use of the illegal drug cocaine may trigger this
type of angina.

ANGINA IN WOMEN

 A woman’s angina symptoms can be different from the classic angina symptoms.
These differences may lead to delays of seeking treatment. For example, chest
pain is a common symptom in women with angina, but it may not be the only
symptom or the most prevalent symptom for women. Women may also
experience symptoms such as:
 Nausea
 Shortness of breath
 Abdominal pain
 Discomfort in the neck, jaw or back
 Stabbing pain instead of chest pressure

RISK FACTORS

 Tobacco use
 Diabetes
 High blood pressure
 High blood cholesterol
 Family history of heart disease
 Older age
 Lack of exercise
 Obesity
 Stress

COMPLICATIONS

 HEART ATTACK
  Pressure , fullness, or a squeezing pain in the center of your chest that lasts for
more than a few minutes
 Pain extending beyond your chest to your shoulder, arm, back, or even to your
teeth and jaw
 Increasing episodes of chest pain
 Prolonged pain in the upper abdomen

SIGNS AND SYMPTOMS

 Shortness of breath
 Sweating
 Impending sense of doom
 Fainting
 Nausea and vomiting

OTHER CONDITIONS THAT

MAY CAUSE ANGINA:

 Pulmonary embolism (a blockage in a lung artery)

 Aortic dissection (tearing of a major artery)
 A lung infection
 Aortic stenosis (narrowing of heart’s aortic valve)
 Hypertrophic cardiomyopathy (heart muscle disease)
 Pericarditis (inflammation of tissues that surronds the heart)
 A panic attack

DIAGNOSIS

 Physical exam
 Ask about the symptoms
 Ask about risk factors (family history of cardiovascular conditions)

TREATMENT

1. Lifestyle changes

2. medicines

3. Cardiac procedures

4. Cardiac rehab
MEDICATIONS

 ASPIRIN AND OTHER ANTI-PLATELET MEDICATIONS

- Reduce the ability of your blood to clot, making it easier for blood to flow through
narrowed heart arteries.
 NITRATES
- Relaxes and widens your blood vessels, allowing more blood to flow to your heart
muscle. Nitrate in pills or sprays act quickly to relieve pain during an event.
 BETA BLOCKERS
- These blocks the effect of the hormone epinephrine, also known as adrenaline. They
help your heart beat more slowly and with less force, decreasing the effort your heart
makes and easing the angina pain.
 STATINS
- Statins lower blood cholesterol by blocking a substance your body needs to make
cholesterol. They help your body reabsorb cholesterol that has accumulated in the
buildup of fats in your artery walls, preventing further blockage in your blood vessels.

Prevention

Angina is a sign that the heart muscle isn’t getting the oxygen it needs.

 Eat lots of fruits, vegetables, whole grains, and low-fat sources of protein such as
nuts and fish
 Exercise regularly
 Maintain a healthy weight and keep diabetes under control
 Quit smoking