Angina and its types by Abu Raihan Shams

Angina and its types by Abu Raihan Shams
Angina Pectoris , Intrpduction and its Types.

1. ANGINA & ITS TYPES
ABU RAIHAN SHAMS
Pharm.D 4
th
yr
1700100350
1

2. DEFINITION
Angina is a type of chest pain caused by reduced blood flow to the
heart.
Angina pectoris is a clinical syndrome of IHD resulting from transient
myocardial ischemia.
It ischaracterized by paroxysmal pain in the substernal or precordial
region of the chest , which is aggrevatedby ab increase in the
demand of the heart and relieved by a decrease work of the heart.
2
ABU RAIHAN SHAMS

3. Angina results when there is an imbalance between the heart's
oxygen demand and supply.
It is a symptom of coronary artery disease.
Angina, also called angina pectoris, is often described as
squeezing, pressure, heaviness, tightness or pain in chest.
Often, the pain radiates to the left arm, neck, jaw or right arm.
It is more common in men past 5th decade of life.
3
ABU RAIHAN SHAMS

4. SIGN & SYMPTOMS
4
ABU RAIHAN SHAMS
oAngina symptoms include chest pain and discomfort, possibly
described as pressure, squeezing, burning or fullness.
oPain may be in arms, neck, jaw, shoulder or back.
oOther symptoms that you may have with angina include:
•Dizziness
•Fatigue
•Nausea
•Shortness of breath
•Sweating

5. CAUSE
Angina is caused by reduced blood flow to heart muscle
The most common cause of reduced blood flow to your heart
muscle is coronary artery disease (CAD).
5
ABU RAIHAN SHAMS
Blood Flow reduction may be due to :-
➢Narrowingorobstructionofarteries
due to plaque formation
➢Coronary Vasospasm

6. PATHOPHYSIOLOGY
6
ABU RAIHAN SHAMS
Due to any cause
Increase oxygen demand in body
Increase heart work load
Heart need more blood supply
Then coronary artery dilate and supply more blood to heart
But due to any factors , blood supply defected
Heart need more blood demand
Decrease oxygen level in heart and develop condition of ischemia
Start angina (pain) in pectoris ( chest muscles)

7. Types of Angina
oStable angina
oUnstable angina
oVariant angina & Microvascular angina
7
ABU RAIHAN SHAMS

8. Stable Angina
8
ABU RAIHAN SHAMS
oIt is the most common type of angina
oIt is also called classical or typical angina.
oIt is usually triggered by physical activity
oIt is caused by the reduction of coronary perfusion due to a fixed
obstruction of a coronary artery produced by atherosclerosis.
oIt occurs when the heart is working harder than usual.
oStable angina isn't a heart attack, but it suggests that a heart
attack is more likely to happen in the future.
oInthistypeofanginapainisrelievedbyrest.

9. Unstable Angina
9
ABU RAIHAN SHAMS
oIt is also called angina at rest
oIt may occur more often and be more severe than stable angina.
oUnstable angina can be caused by blood clots that block or partially
block your heart's blood vessels.
oUnstable angina also can occur with or without physical exertion, and
rest may not relieve the pain& anyepisode of this angina is longer
than 20 minutes
oUnstable angina is very dangerous and requires emergency treatment.
oThis type of angina is a sign that a heart attack may happen soon.

10. Causes of Unstable Angina
10
ABU RAIHAN SHAMS
oUnstable angina is a form of acute coronary syndrome ,which can
result from rupture of an atherosclerotic plaque and partial or
complete thrombosis of a coronary artery.
oMost cases occur from disruption of an atherosclerotic lesion
followed by platelet activation of coagulation cascade that always
result in partial or complete occlusion …
•if this occlusion is untreated ,necrosis ( MI) of the cardiac muscle may
occur.
So, it’s anEMERGENCY situation that requires hospitalization and more
aggressive therapy to prevent myocardial infarction and death.

11. Variant Angina
11
ABU RAIHAN SHAMS
oIt is also called Prinz metal's angina / non classical angina.
oThis type of angina is rare.
oThis type of angina is caused by a sudden spasm in a coronary artery,
which temporarily narrows the artery.
oEmotional stress, smoking, medications that tighten blood vessels
(such as some migraine drugs) and use of the illegal drug cocaine
may trigger Prinz metal's angina.
oVariant angina usually occurs at rest, and the pain can be severe.
oIt usually happens between midnight and early morning.

12. Microvascular Angina
12
ABU RAIHAN SHAMS
oMicrovascular angina can occur with coronary microvascular disease
(MVD). This affects the smallest coronary arteries.
oIn this type, there is chest painbut no coronary artery blockage. Instead,
it happens because smallest coronary arteries aren’t working, so heart
doesn’t get the blood it needs.
oAs well as chest pain, a person may experience:
ofatigue and low energy , sleep problems ,shortness of breath
oMicrovascular angina tends to be more persistent than stable angina. It
often lasts longer than10 minutesand sometimes longer than 30 minutes

13. RISKFACTORS
Anginacan developas a result of:
Stress
Unmanaged Diabetes
Smoking
Low physical activity
An unhealthful diet
High cholesterol levels
Overweight or obesity
Some conditions such as heart disease, diabetes, low blood pressure, metabolic
syndrome
13
ABU RAIHAN SHAMS

14. REFERANCES
❖https://www.mayoclinic.org/diseases-conditions/angina/symptoms-causes/syc-
20369373
❖https://www.webmd.com/heart-disease/heart-disease-angina#1
❖https://www.medicalnewstoday.com/articles/8886
❖Morrow DA, de LemosJA. Stable ischemic heart disease. In: Zipes DP, Libby P,
BonowRO, Mann DL, Tomaselli GF, BraunwaldE, eds.Braunwald'sHeart Disease:
A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier;
2019:chap 61
❖KD TRIPATHI “ESSENTIALS OF MEDICAL PHARMACOLOGY” seventh edition ,
Jaypee brothers medical publishers (P) LTD. Page no.539,560
14
ABU RAIHAN SHAMS

15. 15
ABU RAIHAN SHAMS
THANKS