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Angina By:P. Dhilip Kumar

Angina is chest pain caused by reversible myocardial ischemia. It can be caused by conditions like coronary artery disease that reduce blood flow to the heart. There are different types of angina including stable angina and variant angina. Diagnosis involves a medical history, physical exam, ECG, stress test and sometimes angiography. Treatment includes medications like nitroglycerin, beta blockers, and calcium channel blockers as well as procedures like angioplasty or coronary artery bypass surgery.

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preet kaur
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33 views9 pages

Angina By:P. Dhilip Kumar

Angina is chest pain caused by reversible myocardial ischemia. It can be caused by conditions like coronary artery disease that reduce blood flow to the heart. There are different types of angina including stable angina and variant angina. Diagnosis involves a medical history, physical exam, ECG, stress test and sometimes angiography. Treatment includes medications like nitroglycerin, beta blockers, and calcium channel blockers as well as procedures like angioplasty or coronary artery bypass surgery.

Uploaded by

preet kaur
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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ANGINA

By:p. DHILIP KUMAR


DEFINITION
Angina or chest pain is the clinical
manifestation of reversible myocardial
Ischemia
Causes of Angina
• Non cardiac conditions like anemia,
hypoxemia, anxiety, pneumonia, asthma,
physical exertion, COPD and low blood volume
• Cardiac conditions like coronary artery spasm,
coronary artery thrombosis, dysrrhythmias,
heart failure and valve disorders, aortic
stenosis, cardiomyopathy, tachycardia
Types of Angina
• Chronic stable Angina: It refers to chest pain that occurs intermittently
over a long period with the same pattern of onset, duration and intensity
of symptoms.

• Silent Ischemia: It refers to the ischemia that occurs in the absence of


any subjective symptoms.

• Nocturnal Angina or Angina decubitus: It occurs only at night but not


necessarily when the person is in the recumbent position or during
sleep.

• Prinzmetal’s Angina or Variant Angina: It occurs at rest usually in


response to spasm of a major coronary artery.
PATHOPHYSIOLOGY
Coronary atherosclerosis

Attraction of platelets to the arterial wall

Thrombus adhere to the wall of the artery

Occlusions of the coronary arteries

Lack of blood flow to myocardium

Anaerobic metabolism

Accumulation of lactic acid to the muscles

Angina pectoris
Assessment of Angina
P- precipitating events i.e. what events or activities
precipitated the pain
Q- quality of pain i.e. how is the pain felt whether
dull, aching, squeezing, tight or pressure type
R- Radiation of Pain i.e. to all what areas pain is
radiating
S- severity of pain i.e. on a scale of 0-10 rate the pain
T- timing of pain i.e. when the pain begins and the
duration and frequency of pain
DIAGNOSTIC EVAUATION
• History and physical examination
• ECG
• Chest X-ray
• Exercise stress test
• Echocardiogram
• Nuclear imaging tests
• CT scan
• Positron emission tomography
• Coronary angiography
• Laboratory test- CK-MB, CBC, Lipid profile, C- reactive protein,
myoglobin.
management
• Admn morphine sulfate to reduce pain.
• Drug therapy Anti platelet therapy (Aspirin)
• Admn Inj.Nitroglycerine
• β- Adrenergic blockers (Metoprolol, Inderol)
• Calcium channel blockers (Amlong, Nimodip)
• ACE inhibitors (captopril, ramipril)
• Fibronolytic agents (Streptokinase, Heparin)
• Percutaneous coronary intervention
SURGICAL MANAGEMENT
• Coronary artery bypass graft surgery(CABG)
• Minimally invasive direct coronary artery
bypass
• OFF- PUMP CORONARY ARTERY BYPASS
• Transmyocardial Laser
Revascularization(TMR)

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