Angina Flashcards
What is angina
Reduced bloodflow to the heart due to occlusion of the coronary arteries leading to ischaemia
What are the three forms of angina
Stable, unstable and vasospastic
What is the most common form of angina
Stable
Describe stable angina
Over 70% of artery is occluded and it is blocked by an atherosclerotic plaque.
Main cause of stable angina
Atherosclerosis of coronary artery
Other causes of stable angina
Hypertrophic cardiomyopathy and pumping against high pressure (aortic stenosis or hypertension)
What is the subendocardium and why is it important in angina
Most common area for ischaemia in stable angina and it is between the myocardium and endocardium
What substances does the subendocardium release and what do they do
Adenosine and bradkinin and are said to cause the pain.
Symptoms of stable angina
Crushing/tight pain in the chest that radiates to the jaw, shoulders, left arm and/or back brought on by stress or exercise, SOB and sweating
How long do symptoms last usually
20 minutes and subside with rest
Describe unstable angina
Pain during exercise, stress AND rest. Doesn’t terminate naturally. It is a medical emergency
What is the pathophysiology of unstable angina
Usually due to rupture of plaque that causes thrombosis on top of the plaque.
Describe vasospastic angina
Ischaemia due to coronary artery vasospasms that can happen anytime. An atherosclerosis may or may not be present
What does transmural mean
All of the heart layers and transmural ischaemia is present in vasospastic angina
ECG for the three types of angina
ST depression in stable and unstable (subendothelial ischaemia) and ST elevation in vasospastic (transmural ischaemia)
