Download Angina pain and related Cardiovascular problems

Angina Pain and Related Cardiovascular
Problems
What is Angina Pain?
A condition often referred to as
“angina pectoris” --refers to thoracic pain
originating from a lack of oxygen to the
heart muscle (ischemia)
Described by a feeling of discomfort or
heavy pressure localized in the chest region
How it differs from a Heart Attack…
Angina
pain is a short pain resulting from the
muscle temporarily receiving insufficient
amounts of oxygen
vs.
Myocardium infarction results in cardiac
arrest and permanent damage to the heart
muscle, results from a complete cut off of
oxygen
Types of Angina
1.) Angina of Effort- A medical condition that often results from
atherosclerosis
-arteries can supply sufficient oxygen to resting heart but fail to do so
during periods of exercise or stress resulting in a painful sensation
2.) Variant Angina- An uncommon condition that exists independently of
atherosclerosis
-arteries cannot supply enough oxygen to the resting heart; the condition
does not result from excessive work by myocardium
*can also occur as a result of eating (postprandial) and while sleeping
(nocturnal)
Symptoms of Angina
 Pain/heaviness
under the sternum
 Can be experienced elsewhere (back,
arms, neck, shoulders, or jaw regions)
 Breathlessness and Fatigue
 Increased risk of heart attack
Causes of Angina
Excessive
exercise and stress when
coupled with atherosclerosis (effort)
Insufficient coronary arterial muscle
spasms (variant)
The difference between demand and
supply of blood/oxygen to myocardium
---5% of angina cases actually result from a predisposed heart demanding an
abnormal amount of oxygen to function
*more common in the adult population as risk for coronary heart disease
increases
Detection Methods
Physicians
Electrocardiogram
Stress
–non-invasive (85% accurate)
Tests
Angiograms
–invasive (used in other 15% of cases)
Electrocardiogram
Electrocardiogram*-
useful to confirm
Angina pain and other abnormal features
-must be coupled with some sort of stress
test (before, during, and after)
Echocardiogam- associates symptoms
and ECG levels during a 24 hour period
(used with nocturnal angina)
Angiogram
a
virtual x-ray of coronary arteries
 Image is derived by the placement of a
catheter in a major coronary artery
 Dye is injected to “see” the blood flow to
the heart
 *Most accurate and effective way to
determine presence and severity of angina
Risk Factors
 Cigarette
Smoking (results in atheroma)
 High cholesterol intake (results in atheroma)
 Extreme temperatures
 Emotional Stress
 Alcohol Abuse
 Heredity …ethnic predispositions/diabetes
 Personality Type
Treatments
 Often
can be alleviated within minutes by
relaxation/resting
 Intake of prescribed angina medications
often consisting of nitroglycerin (reduces ischemia)
 Reduce risk factors through conventional
treatments
 Surgical procedures increase blood flow to
the heart
Conventional Treatments
 Exercise/yoga
and even massage therapy
have been said to alleviate painful effects
 Behavioral counseling-reduce cholesterol,
smoking, drinking, and obesity (i.e.- diet)
 Nitroglycerin meds.- increases diameter of
blood vessels (taken orally or transdermally)
 Beta blockers- decrease demand and
workload of myocardium
Surgical Treatments
 Coronary
Bypass Surgery- blood vessel
from leg often grafted on the blocked
artery, increasing blood flow
 Balloon angioplasty- catheter with small
balloon placed into coronary artery to
expand blood vessel
 Angioplasty and bypass surgery often
followed by behavioral counseling to
reduce risk factors like obesity
Final Thought
*We must take preventative efforts to help
reduce the presence of Coronary Artery
Disease, as it is the underlying cause of
angina pain *
Road Map
 Coronary
Heart Disease
– What is it?
 Risk
Factors
– Unavoidable
– Treatable or changeable
 Myocardial
Infarctions
– What is it?
– Symptoms
– Treatment options
What is Heart Disease?
 Called
Coronary Heart Disease or Coronary
Artery Disease
 Diagnosed when arteries that supply blood to
heart muscle becomes hardened and narrowed
– Caused by plaque on inner walls and called
atherosclerosis
– Eventually Heart suffers from lack of oxygen and causes
Angina
Heart Attack (Myocardial infarction)
Clogged arteries
Who can develop Heart Disease?
 Unavoidable
– Age
– Sex
– Heredity
 Treatable
Risk Factors
Risk Factors
– Smoking
– High Blood Pressure
– High Blood Cholesterol
– Physical Activity
– Obesity
– Diabetes
Unavoidable Risk Factors
– Fact of life, everyone
gets older. 83 % of people who die from
Heart Disease is over 65
 Being male – Have a greater risk and die
younger
 Heredity -- Children with parents
suffering from Heart Disease; African
Americans greater risk of High Blood
Pressure and Heart Disease
 Increasing Age
Risk Factors that can be changed or
treated
– Smokers have increased risk 2-4
times greater than non-smokers
 High Blood Cholesterol – The greater
amount of cholesterol greater increase risk of
heart disease
 High Blood Pressure – Greater the
pressure, the harder the heart must work,
causing heart to thicken and stiffer
 Smoking
Treatable Risk Factors (cont)
Inactivity – inactive lifestyle increases
risk of heart disease; regular moderate-tovigorous physical activity helps prevent heart and
blood vessel disease
 Obesity and overweight – people with excess
body fat are more likely to develop heart disease
and strokes
 Diabetes mellitus – Even when glucose levels
are under control, there is still an increased risk,
but risk is greater if left untreated
 Physical
Predicting who will develop heart disease
 Subjects:
2489 men and 2856 women 30 to 74
yrs. Old
– Baseline reading
– 12 years later
Subjects 383 men and 227 women developed heart disease
Those with heart disease were associated with high blood
pressure, total cholesterol, LDL and HDL, sex,
Used prediction equation to predict likelihood of developing
disease
– Age, diabetes, smoking, blood pressure, total cholesterol, and LDL
Results And Discussion
 28
% of male and 29 % female cases attributed to
blood pressure levels that exceeded normal
high130/85
 27 % of male and 34 % female cases attributed to
high total cholesterol (greater than 200 mg/dL)
 Study confirmed the medical guidelines for blood
pressure, total Cholesterol, and LDL as accurate
for predicting risk of middle-aged white population
Myocardial Infarctions

Also known as an MI or heart attack
 Happens when the blood supply to the heart is
blocked long enough to cause death of heart
tissues
 If enough permanent damage occurs, the
patient may die
Myocardial Infarction
Symptoms of MI
 Angina
 Pain
or discomfort in upper arms, left shoulder,
back, neck, jaw or stomach
 Difficulty Breathing
 Sweating or “cold sweat”
 Fullness, indigestion, or heartburn
 Feeling Lightheaded
 Extreme weakness
 Rapid, irregular heart rate
Treatment Options
 Before
getting to the hospital
– Quick response time is critical
– Call 911 if observe symptoms and do CPR if
necessary
– Can take asprin, heprin, antiplatelet drugs,
therombic therapy
 At
the hospital
– Angioplasty
– Bypass surgery