Ana Gašparović

Mentor: A. Žmegač Horvat

Definition
 Generally described as retrosternal
heavy or gripping sensation with
radiation to left arm or neck,
provoked by exertion and eased
with rest or nitrates
Angina can be:
 Stable

 Unstable caused by
unstable plaque, occurs at
rest, unpredictable, pain
can increase for no obvious
reason

 Prinzmetal’s occurs
without provocation,
usually at rest, as a result of
coronary artery spasm
Stable angina pectoris
 Provoked by physical exertion,
especially in cold weather, after
meals and commonly
aggravated by anger or
excitement
 The pain fades quickly with
rest
 In some patients pain occurs
predictably at a certain level of
exertion
Etiology and pathogenesis
 Symptoms are results of myocardial
ischemia due to insufficient blood
flow through atherosclerotically
changed coronary vessels
Clinical symptoms
 Patient history is a˝golden standard˝
 Retrosternal pain
 Dyspnea
 Nausea
 Arrhythmia
 Restlessness
 Levine sign
 Pain eased after taking nitrates
Physical examination
 Hypertension
 Obesity
 Hyperglycemia
 Hyperlipidemia
 Auscultation
Investigations
 Laboratory tests (leukocytes, hemoglobin, thyroid
hormones, troponin I and T, MB-CPK)
 Resting ECG
 Excercise ECG
 Cardiac scintigraphy
 Echocardiography
 Coronary angiography
Treatment
 Prognostic therapy: Aspirin, lipid-lowering therapy
 Symptomatic treatment: GTN, beta-blockers,
long-acting nitrates, calcium-channel blockers, ACEI
 Percutaneous coronary intervention, coronary artery
bypass grafting
 Literature :
P.Kumar and M.Clark: Kumar & Clark’s Clinical Medicine
Božidar Vrhovac and associates: Interna Medicina
Damjanov, Jukić, Nola : Patologija