ANGINA
Definition
Angina pectoris, or angina, is chest pain caused by underlying coronary heart disease resulting in myocardial ischemia. Different types include the following:
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Stable angina ("classic") occurs with exercise, emotional stress, or extreme temperatures. It seldom is associated with permanent damage to the heart muscle.
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Unstable angina occurs even at rest. Patients may present with symptoms resembling a myocardial infarction but with no evidence of heart muscle damage. Unstable angina may progress to acute myocardial infarction and should be treated as an emergency.
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Prinzmetal's or variant angina is a rare condition that occurs at rest and is caused by coronary artery spasm with electrocardiographic changes. This type of angina should be treated as a medical emergency, because it is often associated with acute myocardial infarction, ventricular tachycardia and fibrillation, and sudden cardiac death.
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Microvascular angina is chest pain in patients with no apparent coronary artery blockages and is caused by poor functioning of smaller blood vessels.
Aetiology / Risk Factors
Coronary atherosclerosis and/or coronary artery spasms are usually the root causes of angina. Episodes may be precipitated by exertion, emotional stress, smoking, extreme temperatures, overeating, alcohol, or a combination of these. Unstable angina is associated with inflammatory markers indicating possible immune system involvement.
Symptoms and Signs
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Pressing or squeezing pain under the breastbone, or less often, in the shoulders, arms, neck, jaws, or back, generally brought on by exertion and relieved within a few minutes by rest and/or medication (e.g., nitroglycerine).
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Abnormal electrocardiogram (ECG) including transient abnormality during pain, QRS notching or slurring, ST-segment depression, and T-wave inversion