天津医科大学内科学课件 Angina pectoris.pptVIP

Angina pectoris BIAN BO Tianjin Medical University General Hospital Classification Coronary artery disease Angina pectoris Winter (cold or from warm to cold) Windy After meal Heave stuff Cigarette case1 An old woman, 70 years old, suffered from intermittent breathlessness for 10 years, which was induced by meal, or exercise, and accompanied with palpitation. The symptom released through rest every time. Case 2 A man, 50 years old, feels chest pain after half a mile of walk recently which used be 1 mile before. ECG demonstrated typical variation. Case 3 A man who suffered from myocardial infarction 1 month ago, felt chest pain again, which lasted less than 30 mins. Case 4 Intermittent chest pain happened to a man in 1 month recently who had no history. Case 5 Similarly pain happened to a man at rest which happened after hard work before. definition Chest pain that occurs when the heart is not getting enough blood, often happened within 30 mins. causes Atherosclerosis other reason: Aortic stenosis Hypertrophic cardiomyopathy coronary artery inflammation coronary artery spasm Pathology Not enough blood and waste product accumulation Imbalance of the supply and demand HR×BP (surrogate of oxygen demand) manifestation Symptom Sign Symptom Position Character Inducement Duration Position Typical precordial area and radiation to left arm Untypical teeth neck stomach gallbladder Character Often described as pressure, like a band tightening around the chest, or a dull, aching pain over the left side of the chest. Character The symptoms of angina are experienced in different ways by different people, but an individual usually experiences the same symptoms every time an attack occurs. Inducement Exertion Excitement Cold Meal Other reason such as HF, low BP, dyspnea, arrhythmia. Duration Less than 30mins Sign HR increase Anxiety BP increase laboratory