Angina pectoris

Definition
• Angina pectoris/ stable angina is the medical term for chest pain or
discomfort due to coronary heart disease.
• It occurs when the heart muscle doesn't get as much blood as it
needs. This usually happens because one or more of the heart's
arteries is narrowed or blocked, also called ischemia.
Classification of Angina Pectoris
Clinical Classification of Chest Pain
Typical angina (definite) 1. Substernal chest discomfort with a characteristic
quality (nyeri hebat) and duration (>20 menit, <60
menit) that is
2. Provoked by exertion or emotional stress and
3. Relieved by rest or nitroglycerin
Atypical angina (probable) Meets 2 of the above characteristics
Noncardiac chest pain Meets 1 or none of the typical anginal characteristics
Introduction
• Coronary Artery Disease (CAD) is the most common cause of Angina.
It is pathological process characterized by atherosclerotic plaque
accumulation in the epicardial arteries, whether obstructive or non-
obstructive
• Ischaemic Heart Disease (IHD) is a condition in which is an
inadequate suplly of blood and oxygen to portion the myocardium
associated with disturbance in myocardial function (ACS and CCS)
• Occult CAD is common in those who present with other forms of
atherosclerotic vascular disease, such as intermitten
claudication or stroke.
Natural History of Chronic Coronary
Syndrome
 Pathophysiology

Structural and functional disorders of the

coronary circulation.
CFR, coronary flow reserve;
FFR, fractional flow reserve;
IMR, index of microcirculatory resistance;
HMR, hyperaemic microvascular resistance;
ACh, Acetycholine;
LVH, left ventricular hypertrophy.

Thomas J Ford et al. Heart 2018;104:284-292 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.
 Pathophysiology

Oxidative Stress in Ischemic Heart Disease, Aleksandar Kibel, Ana Marija Lukinac, Vedran Dambic, Iva Juric, and Kristina Selthofer-Relatic
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