Angina Flashcards
Angina Pectoris
severe chest pain originating from heart in response to an inadequate O2 supply to myocardial cells compared to demand
ie. ischemia
precipitating conditions of angina
hyperthyroidism
hypertension
↑physical activity
emotional stress
exposure to cold
anginal pain
experienced as recurrent, intermittent brief episodes of substernal pain that may radiate to neck and left arm
if myocardial dysfunction occurs, dyspnea may develop
what is anginal pain described as
pressure, squeezing, aching or suffocating
what is anginal pain manifested as in ECG
ST segment depression
stable anginal
type of chronic ischemic heart disease associated w/ a stable, fixed obstruction, usually atherosclerotic
stable anginal is precipitated by
↑physical activity
emotional stress
exposure to cold
how long does stable anginal pain last?
usually short-lived (<5mins)
how is stable anginal pain relieved?
w/ rest (↓O2 demand) or administration of nitroglycerin or nitrates
what does it mean if stable anginal pain does not subside?
if pain does not subside within 10mins of rest, pain may be d/t severe ischemia
unstable angina occurs with what kind of pts?
individuals w/ worsening CAD - type of acute coronary syndrome
what happens in unstable angina when atherosclerotic plaque ruptures?
stimulates thrombus formation and vasospasm => more severe, acute ischemia - can progress to MI
what kind of atherosclerotic plaque is believed to involve unstable angina?
atherosclerotic plaques that contain small amounts of fibrous protein and more lipid which predisposes them to rupture
what are unstable angina episodes like?
unpredictable and occur w/o exercise, during sleep or at total rest
unstable angina manifestations
pain similar to stable angina - but lasting up to 20mins
not relieved by rest or nitroglycerin
unstable angina with brief myocardial ischemia
if resulting myocardial ischemia is brief, ventricular dysfunction is completely reversible
unstable angina with persiting myocardial ischemia
if ischemia persists for less than 30mins, ventricle may become “stunned” and have decreased function that can last for weeks
what happens if blood flow is not restored in unstable angina?
if blood flow is not restored within 40-60mins, infarction happens => permanent myocardial dysfunction
following unstable angina is a risk to what?
↑risk of MI
treatment of unstable angina
aspirin
anticoagulants
