“Fermín Valdés Domínguez” Hall of Residence

Intensive English Course

Case Presentation
TITLE

ANGINA PECTORIS

Authors: MercedesFonsecaConcha
Profesor: Alicia Guilarte Barbón
Definition
Angina pectoris is a chest pain often due to ischemia of the Heart muscle, due in
general to obstruction or spasm of the coronary arteries.
Classification:
Stable Angina / Angina Pectoris (Also known as 'effort angina', this refers to the
classic type of angina related to myocardial ischemia.)
Unstable Angina (is defined as angina pectoris that changes or worsens.)
 Variant (Prinzmetal) Angina (occurs in patients with normal coronary arteries or
insignificant atherosclerosis and It is caused by spasms of the artery.)
Microvascular Angina (is characterized by angina-like chest pain, in the context of
normal epicardial coronary arteries)
Signs and symptoms
For most patients with stable angina, physical examination findings are normal. Commonly
the patient can refer retrosternal chest discomfort (pressure, heaviness, squeezing, burning, or
choking sensation) as opposed to frank pain.Usually lasts a short time (10 minutes or less)
and relieved by rest or medicine.
May feel like gas or indigestión.
Mayfeellikechestpainthat spreads tothearms, back, orother áreas
Pain localized primarily in the epigastrium, back, neck, jaw, or shoulders
Pain precipitated by exertion, eating, exposure to cold, or emotional stress, lasting for about
1-10 minutes and relieved by rest or nitroglycerin
Pain intensity that does not change with respiration, cough, or change in position
The pulse rate and the blood pressure increases.
Major risk factors
Age (≥ 45 years for men, ≥ 55 for women)
Smoking
Diabetes mellitus
Dyslipidemia
Family history of premature cardiovascular disease (men <55 years, female
<65 years old)
Hypertension
Kidney disease (microalbuminuria or GFR<60 mL/min)
Obesity (BMI ≥ 30 kg/m2)
Physical inactivity
Stress
Unhealthy diet.
Physical Examination
Examination of patients during the angina attack may be more
helpful. Useful physical findings include third and/or fourth heart
sounds due to LV systolic and/or diastolic dysfunction and mitral
regurgitation secondary to papillary muscle dysfunction.
Tachycardia and hypertension could be present.
Investigations
• Chest radiography:
• ECG
• Selective coronary angiography
• Computed Tomography Angiography
Differential Diagnoses
Acute Gastritis
Acute Pericarditis
Anxiety Disorders
Aortic Dissection
Aortic Stenosis
Biliary Colic
Cholecystitis
Hiatal Hernia
Hypertension
Peptic Ulcer Disease
Pulmonary Embolism
Varicella-Zoster Virus (VZV)
Esophageal spasm
Costochondritis
 Complication:
Congestive Heart failure,
Myocardial Infarction
 Treatment
Non-Pharmacological
Pharmacological
Prognosis : is good
if the patient
follow the medical
prescription
THANKS