IBMS 2 – CASE 2 – ACUTE CORONARY SYNDROME

 Angina pectoris is characterized by repeated episodes of substernal or

precordial chest pain produced by brief (15 seconds to 15 minutes)
myocardial ischemia inadequate to cause myocyte necrosis.
 Ischemia causes the release of adenosine, bradykinin, and other chemicals
that activate sympathetic and vagal afferent neurons, resulting in anginal
discomfort.

Types of Angina

 Stable (typical) angina

o The most usual type of angina is caused by an imbalance
between coronary perfusion and myocardial demand due to
the persistent stenosing coronary atherosclerosis
o Stable angina does not happen at rest, but it can be
consistently triggered by activities that raise the heart's energy
demands, such as physical exertion, emotional excitation, or
psychological stress
o A crushing or squeezing substernal sensation that might extend
down the left arm or to the left jaw is what angina pectoris is
known for also known as referred pain.

 Prinzmetal variant angina

o It's a rare kind of myocardial ischemia brought on by coronary
artery spasm.
o anginal episodes are unrelated to physical activity, heart rate, or
blood pressure and can happen at any time.
o Prinzmetal angina is a kind of angina that responds quickly to
vasodilators.
 Unstable or crescendo angina
o This is a pattern of increasing frequency, duration (>20 minutes),
or severity of angina that is triggered by progressively lower levels
of physical activity or even occurs at rest. Unstable angina is
linked with plaque breakdown and superimposed thrombosis,
distal embolization of the thrombus, and/or vasospasm; it is a key
precursor of MI, since it may indicate total arterial occlusion.