Angina pectoris – clinica; syndrome

Group of 5 symptoms
Paroxysms / pain/ sudden pressure
Cause of this is decrease blood flow = decrease O2 supply
O2

AP- has 2 causes

1. Atherosclerotic – presence of fats, cholesterol
2. Obstruction (complete or partial )
If there is a + obstruction meaning vessels 123 or more vessels ang ma apektohan there is an
increase demand of O2,rr then bp
Factors:

1. Physical exetsion- increase of myocardial o2 demand

2. Exposure to cold – vasoconstriction can elevate BP thus increase O2 demand
3. Eating heavy- flow – mesenteric area it provides oxygenated blood to the interstine
thereby if we eat heavy reducing blood supply to the heart muscles
4. Stress/emotion provoking situation – catecholamines – increases bp, hr, myocardial
workload

Types of angina
1. Stable angina – predictable/pain is consistent
Relieved by rest
Relieved by giving pt nitroglycerin
2. Unstable Angina – preinfarction (nay nagbara) / crescendo angina
Frequency/severity
Cannot be relieved with rest and nitroglycrein
3. Intractable/refractory angina – severe pain pain scale :5000/10
4. Variant Angina/Prinzemetal Angina – Rest still with pain
ECG – st segment elevation it is reversible meaning maulian ra gihapon with meds
5. Silent Ischemia – s/s no pain at all but with ecg signs are present ecg (+)

Cinical manifestations
1.Ischemia – decrease blood flow to the heart muscle
- produce pain
2.Feelinf of choking/ indigestion
3.Impending death
4. pain is radiating felt deep inside the sternum (neck, jaw, r shoulder, left arm
5.feeling of weakness
6.n/v
7.diaphoresis

Patient Hx
Nutrition
 - Perform 12 lead ECG – T wave is nay inversion ST segment – elevate Q abnormal form
- Stress test

Medical management
Decrease O2 demand
Increase O2 supply
Meds: d hr, bp, rr

PCI
CABG Coronary artery bypass graft

Pharmacologic tehrapy
1.nitroglycerin/ nitrates – very potent vasodilator = inc flow of heart muscle then it relieves pain
2.BABA – bETA adrenergic blocking agents – metaprolol helps heart rate to normalize and slow
rr thus it also dec bp
You need to titer before to stop
3Calcium channel blockers - amlodipine (SA/AV nodes) helps pump heart and supply blood