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Angina pectoris

Angina pectoris. 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

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Angina pectoris

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  1. Angina pectoris Ana Gašparović Mentor: A. Žmegač Horvat

  2. 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

  3. 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

  4. 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

  5. Etiology and pathogenesis • Symptoms are results of myocardial ischemia due to insufficient blood flow through atherosclerotically changed coronary vessels

  6. Clinical symptoms • Patient history is a˝golden standard˝ • Retrosternal pain • Dyspnea • Nausea • Arrhythmia • Restlessness • Levine sign • Pain eased after taking nitrates

  7. Physical examination • Hypertension • Obesity • Hyperglycemia • Hyperlipidemia • Auscultation

  8. Investigations • Laboratory tests (leukocytes, hemoglobin, thyroid hormones, troponin I and T, MB-CPK) • Resting ECG • Excercise ECG • Cardiac scintigraphy • Echocardiography • Coronary angiography

  9. 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

  10. Literature : P.Kumar and M.Clark: Kumar & Clark’s Clinical Medicine Božidar Vrhovac and associates: Interna Medicina Damjanov, Jukić, Nola : Patologija

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