Angina Pectoris

Angina pectoris is substernal chest pain due to myocardial ischemia. Angina pectoris can be distinguished from prinzmetal's (varian) angina by definition that prinzmetal's angina is caused by vasospasm of coronary vessels.

Signs and Symptoms:

• Substernal chest pain precipitated by exertion and relieved by rest or nitrates
• Pain radiates to the arms, jaw, and neck
• Shortness of breath
• Nausea or vomiting
• Light-headedness
• Diaphoresis
• Hypertension
• Tachycardia
• Apical systolic murmur or gallop

Diagnoses:

• ST segment depression or T-wave flattening on ECG
• Cardiac enzymes to rule out myocardial infarction

Treatments in Acute Case:

• Morphine
• Oxygen
• Nitroglycerin sublingually
• Aspirin
• IV beta-blocker

Treatments in Chronic Case:

• Nitrates
• Beta-blockers
• Calcium channel blockers
• ASA
• Risk factor reduction such as smoking, cholesterol, hypertension