Angina Pectoris

Angina Pectoris is chest pain caused by reduced blood flow to the heart muscle, often triggered by exertion or stress and linked to coronary artery disease.

• 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

1. Primary Symptoms:

   • Severe chest pain, typically on the left side.
   • Pain may radiate to the neck, back, jaw, and limbs.

2. 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 Angina:

1. 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.

2. Variant Angina (Prinzmetal’s or Vasospastic Angina):

   • Uncommon and unpredictable
   • Occurs at rest and is caused by coronary vasospasm, reducing blood supply and oxygen delivery.
   • Treatment focuses on relieving vasospasms.

3. 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.

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