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- 2. Sudden coronary death Angina pectoris Acute myocardial infarction Painless myocardial ischaemia Heart failure Disturbences of rhythm
- 3. Ischaemic heart disease . Anterior Heart Arteries The coronary arteries supply blood to the heart muscle.
- 4. Ischaemic heart disease . Posterior Heart Arteries The coronary arteries supply blood to the heart muscle.
- 5. Ischaemic heart disease Ischaemic heart disease (Coronary artery disease) – is the most common form of
- 6. ANGINA PECTORIS-DEFINITION Angina pectoris is the clinical symptom complex caused by transient myocardial ischaemia and may
- 7. ANGINA PECTORIS-DEFINITION Angina pectoris is the medical term used to describe chest pains caused by poor
- 9. RISK FACTORS Nonmodifable : Age (> 45 ) Male gender Family history (genetic predisposition) Aethnic origin
- 11. AETIOLOGY There are 2 primary causes of angina. Coronary (heart) artery atherosclerosis In as many as
- 13. INCIDENCE The incidence of angina continuously rises with age in women while in men the incidence
- 14. Identifying ischaemic cardiac chest pain Ischaemic cardiac chest pain: Location - central, diffuse Radiation -Jaw/neck/shoulder/ arm/back
- 15. SIGNS N SYMPTOMS These are signs and symptoms of angina as well: An uncomfortable pressure, fullness,
- 20. CLASSIFICATION Types of Angina Pectoris Stable Angina Unstable Angina Prinzmetal’s or variant angina Microvascular angina
- 21. Stable Angina Stable angina is a repeating pattern of chest pain which has not changed in
- 22. Сanadian Cardiovascular Society Functional classification of Angina ССS separates patients with angina pectoris into groups based
- 23. Сanadian Cardiovascular Society Functional classification of Angina 3 class – marked limitation of ordinary activity. Angina
- 25. Unstable Angina Unstable angina is chest pain that is variable, either increasing in frequency or intensity
- 26. Unstable angina New onset angina pectoris – from first clinical signs of substernal anginal pain or
- 27. Stable angina Fixed stenosis Demand-led ischaemia Related to effot Predictable Symptoms over long term Symtoms on
- 28. Prinzmetal's Angina Prinzmetal’s or spontaneous or angiospastic angina is caused by a vasospasm, a spasm that
- 29. Microvascular Angina or Stable Angina Pectoris on angiographycally intact vessels or Coronary Syndrome X Microvascular angina,
- 30. Coronary Syndrome X Characterized by 3 specific, typical signs as : Classic anginal chest pain ST
- 31. Terminology Clarification One major association between microvascular angina and the insulin resistance syndrome has arisen from
- 32. Diabetes and Angina Insulin resistance and secondary hyperinsulinemia are recognized risk factors for development of atherosclerosis.
- 33. Diagnosis The diagnosis of angina pectoris usually involves a careful assessment and history of signs and
- 34. Laboratory investigations Obligatory indicators: Hb, Total Cholesterol, HDL-C, LDL-C, triglycerides, glucose, AST, ALT, creatinine (GFR) Additional
- 35. Investigations Resting ECG – reversible ST depression or elevation with or without T-wave inversion at the
- 36. Investigations Stress echocardiography – to identify ischaemic segments of myocardium and areas of infarction ( exhibit
- 41. Management The management of angina pectoris involves : A careful assessment of the likely extent and
- 46. Treatment Nitroglycerin is the drug most often used. It mainly relaxes the veins and relaxes the
- 47. Anti-anginals - B- blockers -1st line (metoprolol,bisoprolol,nebivolol,carvedilol) - Calcium antagonists (verapamil , amlodipin,diltiazem if b-blockers contraindicated)
- 48. Treatment ANTI-ANGINAL DRUG TREATMENT – GROUPS OF DRUGS ARE USED TO HELP RELIEVE OR PREVENT THE
- 49. Drugs,which improve prognosis - Antiplatelet drugs (aspirin,clopidogrel ) - Statins (lovastatin,simvastatin, atorva-statin,rosuvastatin ) - B-blockers (atenolol,metaprolol,bisoprolol,nebivolol,
- 50. Treatment Controlling the risk factors for angina pectoris, such as high blood pressure, cigarette smoking, high
- 51. What procedures are used to treat angina? Invasive techniques that improve the heart and the heart's
- 52. Coronary artery bypass graft surgery is also used. In it, a blood vessel is used to
- 53. How is variant angina or Prinzmetal's angina treated? Calcium antagonists are extremely effective in preventing the
- 54. Medical Treatment If you have come to the hospital emergency department, you may be sent to
- 55. Medical Treatment Regardless of where you are sent, several basic treatments may be started. Which are
- 56. Medical Treatment Treatment will depend on the severity of symptoms, severity of the underlying disease, and
- 57. Medical Treatment You may be given medication to lower blood pressure or heart rate. Beta blockers,
- 58. Metabolic therapy - Trimetazidine (preductal) - Riboxin - Mildronate (vasonate) - Tiotriozaline - Vitamins - Antioxidantes
- 59. Medical Treatment After reviewing your immediate test results, the hospital health care provider will make a
- 60. Medical Treatment If you keep having symptoms or your condition is unstable, you will be admitted
- 61. INVASIVE TREATMENT Angioplasty is a treatment used for people whose angina does not get better with
- 62. INVASIVE TREATMENT The catheter is threaded through the arteries and into the artery where the narrowing
- 63. Percutaneous transluminal angioplasty (1, 2)
- 64. Percutaneous transluminal angioplasty (3, 4)
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