Angina Pectoris
Angina pectoris, commonly referred to simply as angina, is a clinical syndrome characterized by ischemic chest pain resulting from an imbalance between the myocardial oxygen demand and supply.
It serves as a symptom of myocardial ischemia, indicating reduced blood flow to the heart muscle.
Pathophysiology
Ischemia: A condition where there is a reduced blood flow to any organ or tissue, leading to a shortage of oxygen (O₂).
Myocardial Oxygen Imbalance: When the heart muscle (myocardium) does not receive sufficient oxygen and blood supply, angina pectoris occurs.
Symptoms
Primary Symptoms:
Severe chest pain, typically on the left side.
Pain may radiate to the neck, back, jaw, and limbs.
Associated Symptoms:
Indigestion
Nausea
Vomiting
Diaphoresis (excessive sweating)
Causes:
Most commonly caused by coronary artery disease.
Atherosclerosis (plaque buildup) narrows arteries and restricts blood flow.
Types of Anginas:
Stable Angina (Classical Angina):
Most common type of angina.
Triggers: Predictable, often induced by physical exertion, stress, or increased workload.
Cause: Atherosclerosis leading to reduced coronary artery perfusion.
Variant Angina (Prinzmetal’s or Vasospastic Angina):
Uncommon and unpredictable type.
Occurs at rest and is caused by coronary vasospasm, reducing blood supply and oxygen delivery.
Treatment focuses on relieving vasospasms.
Unstable Angina:
Occurs at rest with attacks increasing in intensity and duration.
Primarily caused by atherosclerosis due to plaque buildup, which narrows the arteries and restricts blood flow.
Treatment of Angina:
Lifestyle changes: Increased physical activity, weight loss, quitting smoking, and reducing fatty acid intake.
Surgery: Coronary artery bypass surgery.
Medications: Anti-anginal drugs such as calcium channel blockers, vasodilators, and beta-blockers.
