Angina pectoris, or angina, as it is commonly referred to, and coronary artery disease or arteriosclerosis are closely related. Angina occurs in people who have some form of blockage in the coronary arteries. In other words, it occurs in people with coronary heart disease. Angina pectoris: a heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart. It occurs when the Oxygen Supply to the Myocardium is insufficient for its needs.
Types f Angina
- Stable angina
- Unstable angina
- Variant angina (prinzmetal's angina )
- Microvascular angina
Stable angina :
Stable angina is Predictable Occurs on exercise, emotion or eating. Caused by increase demand of the heart and by a fixed narrowing of coronary vessels. Coronary obstruction is ‘fixed’ Blood flow fails to increase during increased demand despite the local factors mediated ‘vasodilation’ and so ischeamic pain is felt.
Unstable angina :
This is characterized by Pain that occurs with less exertion , cumulating pain at rest. The pathology is similar to that involved in Myocardial Infraction, namely platelet-fibrin thrombus associated with a ruptured plaque, but without complete occulation of the vessels. The risk of infraction is large, and the main aim of therapy is to reduce this
Variant angina (prinzmetal's angina )
Uncommon Occurs at rest generally during sleep Caused by Large Coronary Artery Spasm Usually with abnormally reactive and hypertrophied segments in the Coronary Artery. Drugs aimed at preventing & relieving Coronary Spasm.
Microvascular Angina :
Microvascular Angina or Angina Syndrome X is characterized by angina-like chest pain, but the cause is different. The cause of Microvascular Angina is unknown, but it appears to be the result of spasm in the tiny blood vessels of the heart, arms, and legs. Since microvascular angina is not characterized by arterial blockages, it is harder to recognize and diagnose, but its prognosis is excellent
Major risk factors
- Age (≥ 55 years for men, ≥ 65 for women)
- Cigarette smoking
- Diabitis Mellitus
- Dyslipidemia
- Family history of premature cardiovascular disease (men <55 years, female <65 years old)
- Hypertension (HTN)
- Kidney disease (microalbuminuria or GFR<60 mL/min)
- Obesity (BMT ≥ 30 kg/m2)
- Physical inactivity
- Prolonged psychosocial stress
- Medications
- Vasodilators
- Excessive thyroid replacement
- Vasoconstrictors
- Polycythemia which thickens the blood causing it to slow its flow through the heart muscle
- Hypothermia
- Hypovolaemia
- Hypervolaemia
- Profound /deep anemia
- Uncontrolled HTN
- Hyperthyrodism
- Hypoxemia
- Tachyarrhythmia
- Bradyarrhythmia Valvular heart disease
- Hypertrophic cardiomyopathy
- Nitroglycerin.
- Beta blockers
- Calcium channel blockers
- ACE inhibitors
- Coronary artery bypass graft (CABG)
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