Angina : Angina pectoris

definition
pathophysiology
clinical signs
additional examinations
complications
treatments


definition

    Angina is chest pain syndrome in relation hypoxia infarction related to an imbalance between inputs and oxygen requirements . Risk of myocardial infarction.


pathophysiology

    Imbalance between needs and intake oxygen infarction. This imbalance is responsible for suffering an ischemic infarction may be due to:

Coronary obstruction .
Atherosclerosis: dead pile fibers of which that block the artery , causing hypoxia.
Coronary spasm : constriction of the coronary artery.
The decrease in coronary flow :
Rhythm disorder .
Valvulopathy .

clinical signs

Stable angina : angina of effort

Stable angina occurs during exertion .
Retrosternal pain : behind the breastbone.
Pain is constrictive , it lasts 1-3 minutes.
Response to nitroglycerin : pain disappear taking nitroglycerin : coronary vasodilator .
spontaneous angina

The spontaneous angina occurs during rest, it is spontaneous .
Retrosternal pain .
Constrictive pain , it lasts 10 to 15 minutes.
Response to nitroglycerin : pain disappear taking nitroglycerin : coronary vasodilator .
Unstable angina : the syndrome of threat

The unstable angina is the most serious stage of coronary artery disease , there is a threat of myocardial infarction.
Chest pain which become more frequent , intense, long : 30 minutes.
Resistance to nitroglycerin : the pain does not disappear taking nitroglycerin : there is no coronary vasodilation .

additional examinations

ECG during the crisis as more likely to see defects.
Stress Test 's ECG with
Holter : small ECG carried by the patient for 24 or 48 hours.
Unsystematic coronary angiography.

complications

Threat syndrome : unstable angina.
Myocardial infarction.
heart failure
Sudden death .

treatments

pharmaceuticals

Nitrates ( nitroglycerin ) : increases oxygen intake opening in the arteries.
The β -blockers : causes a decrease in heart rate, thus a decrease in oxygen requirements .
Calcium channel blockers : dilates coronary arteries and therefore increases the oxygen supply .
therapeutic indications

Angina of effort and spontaneous angina

If more than 5 crises hospitalization.
Therapy.
Treat high cholesterol .
Smoking cessation.
Weight loss if obesity.
A sporting activity .
unstable angina

Hospitalization.
Incision venous glucose .
Surgery : Coronary artery bypass .
Coronary dilation .