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Angina pectoris

Stable angina

Risk factorsFixedAgeMalePositive family historyDeletion in the angiotensin converting enzyme gene

Risk factorsPotentially changeableHyperliedimiaSmokingHypertensionDiabetes mellitusLack of exercise

Risk factorsPotentially changeableBlood coagulation factorsC reactive proteinPersonalityObesityGoutDrugsalcohol

diagnosis clinical HistoryChest pain heavy gripping tight

diagnosisChest pain centralRetro sternal radiate to jaw ,shoulder or arms

anginaClassical or exertional anginaDecubitus anginaNocturnal anginaPrinzmetal,s anginaCardiac syndrome x

Classical anginaProvoked by physical exerciseAfter meals cold weatherAnger or excitement

Classical anginaPain fades away in minutesDisappears with exertion or walking through the painPain threshold is predictable or can be variable

decubitus anginaAngina on lying down

Nocturnal anginaOccurs at night and may wake the patient from sleep

Variant or prinzmetal anginaAngina without provocation usually at rest .

Cardiac syndrome xGood history of anginaPositive exercise tolerance testNormal coronary angiography

investigationsResting ECGExercise ECGCardiac scintigraphyEchocardiographyCoronary angiographyCT coronary angiographyCardiovascular magnetic resonance

Management of anginaSurgical Percutaneous transluminal interventionCoronary artery bypass grafting

Management of anginaMedical treatmentAspirinLipid lowering drugsNitratesBeta blockersCalcium channel blockersnicorandil

Management of anginaSurgical Percutaneous transluminal interventionCoronary artery bypass grafting

Prevention policyEstablished diseaseAsymptomatic individuals at risk 10 years risk is more than 5%High cholesterolBlood pressureDiabetes mellitusClose relatives

Prevention policyTotal risk in asymptomatic people as a guide to prevention strategies.

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