Angina Pectoris And Coronary Disease

To determine if the patient’s chest pain is related to cardiac ischemia, you would look for ST-segment depression and/or T wave inversion. If the ST-segment depression is at least 1mm (one small box) below the isoelectric line, it is significant and occurs in response to inadequate supply of blood and oxygen, which leads to an electrical disturbance. Once this is treated, adequate blood flow is restored, the ECG changes will resolve, and the ECG will return back to patient’s baseline.

Clearly differentiate the pathophysiology of angina and myocardial infarction, including signs and symptoms. (5 marks)

Chest pain is posed as life threatening-has many definitions ranging from either stabbing, dull, crushing or burning. In certain cases, pain travels up the neck, the jaw, can radiate to the back or down one or both arms. Many different problems can cause chest pain and it can be difficult to determine the exact cause of chest pain (Burman et al’, 2011). Patients’ experiencing chest pain is symptoms consistent with, myocardial ischemia and is a common reason for presenting to ED (Pub Med Central, 2010).

Chest pain is a very common symptom, and around 20% to 40% of the general population will experience chest pain in their lives(149). In the UK, up to 2 % of visits to a general practitioner are due to new onset chest pain (150). Approximately 5% of visits to the emergency department are due to a complaint of chest pain, and up to 40% of emergency hospital admissions are the result of chest pain(149, 151). Approximately 52,000 new cases of angina per year are diagnosed in men and 43,000 in women. The incidence of angina increases with age(123).

Stable – Usually happens with physical exertion, but will get better when the person relaxes or rest. The reason for this is that the persons’ coronary arteries are severely narrowed because of plague. When a person is sedate, then the demand for blood is low so that they do not feel any symptoms. When they exert themselves with exercise or do strenuous work then the heart works harder and needs more blood and oxygen, but it cannot get it due to the narrow arteries.

Angina is a chronic condition characterised by pain or constructing discomfort which usually occurs in the front of the chest and then radiates to the neck, shoulders, jaws or arms. It is typically aggravated by exertion or emotional stress and only lasts for a few minutes (NICE, 2011). Along with chest pain, there are also atypical symptoms which can occur, such as breathlessness, nausea, feeling unusually tired, and dizziness (Sarembock et al., 2007). Stable angina results from the formation of atherosclerotic plaques in the coronary arteries, causing progressive narrowing of the arterial lumen and symptoms occur when the restricted blood flow does not provide adequate amounts of oxygen to the myocardium when there is increased oxygen demand

The onset of symptoms is sudden when thrombus formation is the direct cause of unstable angina. Following the onset of symptoms, unstable angina progresses rapidly and ends in severe symptoms at rest. The rupture of a vulnerable plague with thrombus formation influences the fast change from a stable to unstable lesion (Wilensky, 2012).

The Canadian Cardiovascular Society comes up with a system that is generally accepted to grading angina pectoris. The grading can be seen in table

The overall character of isolated MB usually shows a benign condition. In asymptomatic patients, therapeutic intervention is not warranted, but in symptomatic patient’s therapy may be initiated to improve quality of life, particularly if there is objective evidence of myocardial ischemia. The main treatment strategy can be divided into three groups: medical therapy, PCI and surgical therapy. Obviously, medical therapy should be the first and principal strategy, and interventions should be limited to patients with refractory angina despite medical therapy.

The first case study we will be analysing is a 60-year-old male patient named Mr. John Smith. It was noted that recently he has been experiencing strong chest pain, and the onset pain was described as sudden. Also, no vital signs were noted and the patient had no previous medication history. And also, it has been

A ordinary indication. is chest pain, or uneasiness, which may’ progress into the cholesterol’, , and excessive alcohol, poor diet,between others. Other risks consist of depression,. The primary mechanism, involves ‘atherosclerosis of the arteries of the heart’ A number of tests can help out with diagnose with: ‘electrocardiogram, ‘coronary computed’ ‘topographic angiography, and ‘coronary angiogram, among

The signs and symptoms of atherosclerosis are exceptionally deceitful. The symptoms of this disease happen prematurely and develop mutely. When the symptoms indeed start to come about, it is an advanced and severe problem. There are tests for atherosclerosis, but none of them are without fault. Some tests have risk of injury, so testing is not as easy and simple as some might assume. There are three serious diseases caused by atherosclerosis: Coronary artery disease, cerebrovascular disease, and Peripheral arterial disease. The warning signs of Coronary artery disease are usually chest pain when one is active, or angina. Angina is a symptom of heart disease; it happens when there is an extremely insufficient blood flow to the heart muscle. This is a result of constricted blood vessels, typically caused by hardening of the arteries.2 Angina is frequently described as tightness in the chest region

Angina, which is sometimes called angina pectoris, is chest pain that is caused by inadequate coronary blood flow to the myocardium. When coronary blood flow cannot deliver sufficient oxygen to support cardiac oxidative metabolism (reduced oxygen), the myocardium becomes hypoxic. This triggers pain receptors within the heart, which lead to chest pain and the sensation of heaviness and pressure.

A heart attack is caused by the formation of a blood clot on a cholesterol plaque located on the inner wall of an artery to the heart (coronary artery). Cholesterol is a fatty chemical that is part of the outer lining of cells in the body. Cholesterol plaque is the formation of a hard, thick substance on the artery walls which is caused by deposits of cholesterol on the artery walls; a process that begins in the late teens. Over time, the accumulation of cholesterol plaque causes thickening of the artery walls and narrowing of the arteries; a process called atherosclerosis. Plaque accumulation can be accelerated by smoking, high blood pressure, elevated cholesterol, and diabetes. Ultimately, atherosclerosis causes significant narrowing of the coronary arteries. During exercise or excitement, the narrowed coronary arteries cannot increase the blood supply to meet the increased oxygen demand of the heart muscle.

Angina is a severe pain in the chest that is caused due to ischemia of the heart muscle. It happens due to lack of blood which results in shortage of oxygen. Generally there may be obstruction or spasm of the heart blood vessel called the coronary arteries that creates a feeling that the heart is strangled. Angina may or may not cause a heart attack with or without pain. Nevertheless there can be pain in other part of the body like shoulders, arms, jaw, neck and back.