Angina Pectoris

Angina pectoris is the result of myocardial ischemia caused by an imbalance between myocardial blood supply and oxygen demand.It usually occurs on exertion and is relieved by rest. Angina generally is a symptom of coronary artery disease. In most severe cases, it may occur with minimal effort or at rest.

Predisposing factors:

• Sex - male
• Race - black
• Smoking
• Obesity
• Hyperlipidemia
• Sedentary lifestyle
• Diabetes Mellitus
• Hypothyroidism
• Diet - increased saturated fats
• Type A personality

Precipitating factors:
 
4 E's of Angina Pectoris

• Excessive physical exertion - heavy exercises
• Exposure to cold environment
• Extreme emotional response - fear, anxiety, excitement
• Excessive intake of foods rich in saturated fats - skimmed milk

 Signs and Symptoms

• Levine's Sign - initial sign that shows the hands clutching the chest.
• Chest pain characterized by sharp stabbing pain located at sub sterna usually radiates from back, shoulder, arms, axilla and jaw muscles, usually relieved by rest or taking nitroglycerine,
• Dyspnea
• Tachycardia
• Palpitations
• Diaphoresis

Diagnostic Procedure:

• History taking and physical exam
• ECG tracing reveals ST segment depression 
• Cardiac enzyme levels - CK-MB
• Stress test - treadmill test, reveal abnormal ECG
• Serum cholesterol and uric acid increase

Treatment of Angina Pectoris
The following are some of the latest treatments for Angina Pectoris:

• Oxygen
• Coronary artery bypass graft
• Stent
• Drug eluting stent
• Angioplasty
• Atherectomy

In most instances, drugs are recommended for the treatment of angina before surgery is considered.
The major classes of drugs used to treat angina include the following:

• Nitrates
• Beta-blocking Drugs
• Calcium-channel Blocking Drugs