Ali Al-NasrullahAngina Pectoris

Learning Objectives

• Definition of angina.• General symptoms of angina.• Types of angina.• 1 Question about the case

Angina Pectoris

• is recurring acute chest pain or discomfort resulting from decreased blood supply to the heart muscle (myocardial ischemia).• “Increasing Demand of oxygen but the heart

can’t supply”

• Generally due to obstruction or spasm of the coronary arteries.

• The chest pain comes either as a form of pressure or discomfort

General Symptoms

• Severe chest discomfort (heaviness, pressure, tightness, choking, squeezing)

• The pain may radiate to the shoulders, arms, back, neck, or jaw.

• Palpitations

• Sweating

• Dizziness

• Dyspnea

Types

• Angina is consisted of three types:

• Stable

• Unstable

• Variant (Prinzmetal's Angina)

Stable Angina

• Most common type

• Induced by physical activity (increase demand of O2), or emotional stress.• And can’t be supplied because of partially

occluded coronary artery caused by atherosclerosis)

• The pain is relieved by rest.

Unstable Angina

• Dangerous and requires emergency treatment.It is the rupture of the fibrous cap, leading to the blockage of the

artery by clotted blood.

• Occurs with increasing frequency (progression)

• Affects the patient's life by not being able to work.

• Low response to therapy and could lead to MI.

Prinzmetal's Angina

Usually affects arteries already narrowed by atherosclerosis

•Occurs when  a person is at rest or sleep

•The pain is induced from the spasm of the coronary artery.Thereby when the coronary artery is going to spasms it narrows the artery thus lowering the amount of blood to the heart.

•The pain is fluctuated during the day (come and goes)

The Case

• The patient’s pain is:

• 1- Tight feeling on the chest (Angina)• 2- During walking or cycling (physical activity)• 3-Disappears in rest

• What type of angina is this ?

Answer

Stable Angina