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Questions and Answers
What primarily causes angina pectoris?
What primarily causes angina pectoris?
- Increased blood volume in the heart
- Insufficient oxygen supply to meet metabolic demands (correct)
- Decreased blood pressure
- Excessive ventilation during exercise
Which characteristic is typical of stable angina?
Which characteristic is typical of stable angina?
- Chest pain that occurs at rest only
- Pain lasting longer than 30 minutes
- New onset with prolonged symptoms
- Predictable, intermittent chest pain during activity (correct)
Which treatment is typically used to relieve angina symptoms?
Which treatment is typically used to relieve angina symptoms?
- Antibiotics
- Beta blockers (correct)
- Surgery only
- Oxygen therapy exclusively
What is the primary mechanism associated with unstable angina?
What is the primary mechanism associated with unstable angina?
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What non-pharmacological treatment is recommended for managing angina?
What non-pharmacological treatment is recommended for managing angina?
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Study Notes
Pathogenesis and Mechanisms
- Insufficient oxygen supply leads to angina pectoris, failing to meet myocardial metabolic demands.
- Atherosclerosis contributes significantly to oxygen deprivation.
- Thrombus formation may obstruct coronary arteries, further reducing blood flow.
- Coronary artery spasms can temporarily restrict blood flow, inducing angina.
Types of Angina
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Stable Angina:
- Triggered by increased activity or stress.
- Characterized by predictable, intermittent chest pain.
- Symptoms typically relieved by nitroglycerin, indicating transient ischemia.
- Electrocardiogram may show ST segment changes and T-wave inversions.
- Troponin levels remain normal, indicating no significant myocardial injury.
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Unstable Angina:
- Results from plaque rupture leading to thrombosis.
- Presents as new, prolonged, and worsening chest pain.
- Described as tight or squeezing, lasting 5-15 minutes.
- Relieved by rest or nitrates; often associated with dyspnea and sweating.
- Indicates increased myocardial oxygen demand and potential for heart attack.
Treatment Approaches
-
Pharmacological Management:
- Nitrates: Administer nitroglycerin 0.3 - 0.6 mg every 5 minutes, up to 3 doses.
- Beta Blockers: Metoprolol 25 - 50 mg twice daily to lower sympathetic activity.
- Calcium Channel Blockers: Amlodipine 5 - 10 mg once daily to aid with vasodilation.
- Aspirin: Recommended 25 - 100 mg daily to prevent thrombus formation.
- Statins: Atorvastatin 20 - 40 mg once daily to manage cholesterol levels.
- ACE Inhibitors: Ramipril 2.5 - 10 mg once daily to improve cardiac function.
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Non-Pharmacological Management:
- Encouragement of lifestyle modifications including diet and exercise.
- Possible interventions include Percutaneous Coronary Intervention (PCI) or bypass grafting to restore coronary flow.
Additional Information
- Management of angina involves improving coronary blood flow combined with lifestyle changes for optimal health.
- Effective communication with healthcare providers is essential for symptom management and medication adherence.
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