DEFINITION ANGINA PECTORIS :is a clinical syndrome characterized by paroxysmal chest pain due to transient myocardial ischemia. It may be occur whenever there is imbalance between myocardial oxygen supply and demand. The most common cause is atherosclerosis, aortic stenosis, and hypertrophic cardiomyopathy.
TYPES OF ANGINA 1. Stable angina. 2. Unstable angina.
STABLE ANGINA is the angina that occurs when coronary perfusion is impaired by fixed or stable atheroma of coronary arteries i- e patient has fixed capacity of exertion after that he starts feeling chest pain.
UNSTABLE ANGINA is the angina that is characterized by rapidly worsening chest pain, pain on minimal exertion or pain at rest. The lesion is usually a complex ulcerated or fissured atheroma with adherent platelet –rich thrombus and local coronary spasm. Unstable angina = ulcerated atheroma +thrombus formation+ abrupt reduction of coronary blood flow caused by thrombus formation + angina at rest. The obstruction is not complete.
TYPICAL ANGINA PAIN SITE : pain may arise in one of the following sites : 1. Middle or lower sternum. 2. Left precordium. 3. Epigastrium. 4. Left shoulder or left upper arm. 5. Lower jaw. 6. Interscapular region.
DEFINITION Acute ischemic necrosis of an area of myocardium is known as myocardial infarction, OR myocardial necrosis occurring as a result of critical imbalance between coronary blood supply and myocardial demand is called myocardial infarction. It has the the same symptoms and signs, etiology, as angina pectoris.
INVESTIGATION The same as angina pluse : CARDIAC ENZYMES mainly troponin T.