ANGINA PECTORIS
PRESENTER:GROUP 3
MODERATOR:MR
NCHIMUNYA
1.What is angina
pectoris?
QUESTIONS 2.What are the signs
and symptoms of
this disease?
QUESTION 1
Angina derived from a latin word
angere “strangle” pectoris comes
from pectus “chest”.
Definition:It is an intermittent
substernal chest pain caused by
transient, reversible myocardial
ischemia.
Common cause is coronary atery
atherosclerosis..
TYPES.
Typical orchronical stable angina
Symptoms are reproducible/predictable and severity, frequency,
and threshold for reproduction of symptoms do not change.
Symptoms often subside within minutes with rest or after
administration of nitroglycerin
Common triggers include physical/mental stress or exposure to
cold
Unstable angina (also called crescendo angina)
is characterized by increasingly frequent pain
precipitated by progressively less exertion or even occurring at
rest. Unstable angina is associated with plaque disruption and
superimposed thrombosis.
may signal an incoming MI
CONT…
3.Prinzmetal or variant or vasospastic angina
occurs at rest and is caused by coronary artery spasm.
Although such spasms typically occur on or near existing
atherosclerotic plaques, a completely normal vessel can be
affected.
Prinzmetal angina typically responds promptly to vasodilators
such as nitroglycerin and calcium channel blockers.
SIGNS AND SYMPTOMS
• Classical angina is characterized by chest pain that is
described as ‘heavy’, ‘tight’ or ‘gripping’.
Typically, the pain is central/retrosternal and may radiate to the
jaw and/or arms.
Common triggers include: exercise, emotional stress, when
walking up slopes, cold weather, smoking heavy meals.
SIGNS AND SYMPTOMS
CONT..
Pain referred to the left arm, neck, jaw, epigastric region, or back.
Gastrointestinal discomfort (symptoms of indigestion)
Dyspnea
Dizziness
palpitations
Restlessness,
anxiety
diaphoresis
nausea
vomiting
syncope
SIGNS
These may be seen by performing a physical examination
-xanthelesma which is the deposit of lipids in the skin of the eyelids
.
-Carotid bruit on Auscultation
-Ankle brachial index:decresed artery pulsation in lower limbs
-Fundus examination to elicit htn
nicotine stains in smokers
-Auscultation in lateral decubitus elicits aterial bruits as well as s3
and s4 which are markers of diastolic and systolic dysfuction.
IMAGING
MODALITIES
1.ECG
If done during an angina attack, ECG is likely to
show reversible ischemic changes:
- ST-segment depression (down sloping ST
depression)
- ST-segment elevation
- Decreased R-wave height
- Intraventricular or bundle branch conduction
disturbances
-Arrhythmia (usually ventricular extrasystoles)
2. CHEST X-RAY
Most patients with angina pectoris have a normal
chest X-ray
Although the X-ray may be normal, it might show
indirect signs of underlying heart disease:
Cardiomegaly: Enlargement of the heart,
indicating chronic heart disease.
Pulmonary Congestion: Fluid buildup in the lungs,
suggesting heart failure, which can occur in
advanced coronary artery disease.
Aortic Atherosclerosis: Calcifications in the aorta,
which can indicate widespread atherosclerosis.
3. CT ANGIOGRAPHY
Left Coronary artery stenosis.
narrowing of other coronary arteries, e.g., RCA,
LCx, LAD
can provide information on several parameters
(e.g., coronary blood flow, pressure within heart
chambers, cardiac output, oxygen saturation)
CT SCAN CHEST
Calcified or non calcified plaque
Stenosis of coronary arteries
Cardiac chamber enlargement
Aortic aneurysms and dissections
HOLTER MONITORING
Why it's done
A health care provider may
recommend a Holter monitor if you
have:
Signs and symptoms of an irregular
heart rhythm (arrhythmia)
Unexplained fainting
A heart condition that increases the
risk of arrhythmias
Before you get a Holter monitor,
you'll have an electrocardiogram
(ECG or EKG). An ECG is a quick and
painless test that uses sensors
(electrodes) taped to the chest to
check the heart's rhythm.
If you have infrequent arrhythmias,
an ECG may not detect them. A
Holter monitor may be able to spot
irregular heart rhythms that an ECG
