1

Ar-Rad Ayah: 28
Those who believe (in the Oneness of Allah - Islamic Monotheism), and whose hearts find rest in the
remembrance of Allah, Verily, in the remembrance of Allah do hearts find rest.
 2

ANGINA
 DESCRIPTION 3

 American Heart Association describe

Angina as:
Chest pain or discomfort caused when your heart muscle
doesn't get enough oxygen-rich blood. It may feel like
pressure or squeezing in your chest. The discomfort also can
occur in your shoulders, arms, neck, jaw, or back. Angina
pain may even feel like indigestion. Angina is not a disease, It
is a symptom of an underlying heart problem, usually
coronary heart disease. Over time, the coronary arteries that
supply blood to your heart can become clogged with plaque.
If one or more arteries are partly clogged, not enough blood
can flow through, and you can feel chest pain or discomfort.
Angina can also be a symptom of coronary microvascular
disease (MVD). This is heart disease that affects the heart’s
smallest coronary arteries and is more likely to affect women
than men. Coronary MVD also is called cardiac syndrome X
and non-obstructive CHD.1
NORMAL Functions OF CARDIO 4
VASCULAR SYSTEM
 Composed of a muscular organ and blood vessels.2
 Chambers of heart
 Deoxygenated blood circulation
 Oxygenated blood circulation
 Pressures in heart
 Septum in heart3
 5

Role of
Coronary
Arteries
Role of Coronary 6

Arteries
Left coronary artery branches
Left coronary artery supplies
Right coronary artery branches
Right coronary artery supplies
Collateral Circulation 4
CORONARY ARTERY 7

DISEASE
Occurrence
Etiology
Consequences5
Coronary artery disease 8

leading to Angina
The severity of condition depends
on;
Degree of stenosis2
Ischemic Vascular Disease 6
9
Other Conditions 10

Coronary
microvascular
disease7
Coronary vascular
steal2
 11

Pathophysiology
of Angina
12
Mechanism of Cardiac 13

compensation
Auto regulation
Mediator of Perfusions
Role of endothelial layer8
TYPES OF ANGINA 14
Chronic stable angina 15

Cause
Criticalstenosis
Demand Ischemia
Exertional angina
UNSTABLE ANGINA 16

Cause
Atherosclerosis
Supply Ischemia
Infarction chances
Variant angina 17

Cause
Sympathetic effect 9
Other less common 18

angina
Microvascular angina
Atypical angina10
TABLE 3. CLASSIFICATION OF ANGINA SEVERITY ACCORDING TO THE CANADIAN
CARDIOVASCULAR SOCIETY
19
Class Level of Symptoms

'Ordinary activity does not cause angina 'Angina with strenuous or rapid or prolonged
Class I
exertion only

'Slight limitation of ordinary activity 'Angina on walking or climbing stairs rapidly,

Class II walking uphill or exertion after meals, in cold weather, when under emotional stress, or
only during the first few hours after awakening

'Marked limitation of ordinary physical activity 'Angina on walking one or two blocks on
Class III
the level or one flight of stairs at a normal pace under normal conditions

Class IV 'Inability to carry out physical activity without discomfort' or 'angina at rest'
 SYMPTOMS OF ANGINA 20
 Chest pain is the symptom, but it affects people differently. You
may feel:
 Aching
 Burning
 Discomfort
 Feeling of fullness in the chest
 Heaviness
 Pressure
 Squeezing
 shortness of breath,
 sweating
 Dizziness
 Nausea11
Risk Factors of Angina 21
 High cholesterol
 High blood pressure
 Smoking
 Diabetes
 Obesity
 Lack of physical activity
 Age (greater for men over 45 years and women over 55 years)
 Family history of heart disease
 Stress and anxiety
 Sleep deprivation
 For women: a history of preeclampsia and pregnancy-related diabetes12
Triggers of Angina 22

 physical exertion
 severe emotional stress
 a heavy meal
 exposure to extreme temperatures
 smoking may trigger angina attacks13
 23

Diagnosis of
Angina
GENERAL INVESTIGATIONS 24

 In addition to a complete medical history and medical

examination, a physician can often diagnose angina pectoris by
noting the patient's symptoms and how/when they occur.
 Patients being investigated for angina should have the following
investigations
 Hemoglobin measurement to identify anemia
 Thyroid function measurements to identify thyroid disease
 Blood glucose measurement to identify diabetes mellitus
 Serum cholesterol measurement
An electrocardiogram 25

(ECG or EKG)
An electrocardiogram 26

(ECG or EKG)
27
An angiogram 14
28
OTHER Diagnostic 29

Procedures
Stresstest With Imaging
Blood test
Chest X-Ray
Magnetic Resonance Imaging
OTHER Diagnostic 30

Procedures
Echocardiogram
Coronary computed tomography (CT) angiography
CT of the Chest
Stress test with Imaging15
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32
 References 33
1. http://www.heart.org/en/health-topics/heart-attack/angina-chest-pain
2. https://www.chop.edu/pages/how-normal-heart-works
3. https://www.nottingham.ac.uk/nursing/practice/resources/cardiology/function/anatomy.php
4. https://my.clevelandclinic.org/health/articles/17063-heart--blood-vessels--your-coronary-arteries
5. https://medlineplus.gov/coronaryarterydisease.html?utm_expid=.3gPvYmGMQ0e2jK57JOKdoA.0&utm_referrer=
https%3A%2F%2Fwww.google.com.pk%2F
6. https://www.thrombosisadviser.com/coronary-and-peripheral-artery-
disease/?gclid=EAIaIQobChMIkfaG2K3i3QIVjlYNCh27zAKBEAAYASAAEgI2oPD_BwE
7. http://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/coronary-microvascular-disease-mvd
8. https://www.uspharmacist.com/article/the-pathophysiology-and-treatment-of-stable-angina-pectoris
9. https://www.cvphysiology.com/CAD/CAD007
10. https://www.pfizer.ca/sites/g/files/g10017036/f/201410/Angina.pdf
11. https://www.webmd.com/heart-disease/heart-disease-angina#2
12. http://www.secondscount.org/heart-condition-centers/info-detail-2/angina-causes-risk-factors-2#.W7C2NNczZdg
13. https://www.medicalnewstoday.com/articles/8886.php
14. https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/angina-
pectoris/diagnosis/angiogram.html
15. https://www.radiologyinfo.org/en/info.cfm?pg=anginapectoris
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