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Cardiovascular Emergencies    SAMPLE COURSE
Angina

Angina pectoris is chest pain due to myocardial ischemia. Angina pectoris literally means "choking in the chest." It is caused when not enough oxygen reaches the myocardium. The characteristics of angina-related pain are described as follows:

  • brought on by exercise, stress or cold weather
  • possible radiation of pain to jaw, arm or upper back
  • sudden onset
  • usually relieved with rest within 3-5 minutes and/or nitroglycerin

+ Elaboration — Physiology of Angina

Angina occurs when a person with atherosclerosis exerts or is stressed. The heart muscle does not receive adequate blood flow and thus it becomes ischemic. Anaerobic metabolism begins and produces lactic acid and carbon dioxide.

The accumulation of lactic acid and carbon dioxide in the myocardium causes pain. This process generally does not occur when the patient is at rest. It often occurs when the workload of the heart increases due to exercise, exertion or stress.

+ Elaboration — Signs of Stable Angina

There is typically a regular pattern to stable angina. It can be triggered by physical exertion, stress or cold weather. The pain can radiate to the jaw or arm. The pain usually goes away in a few minutes with rest or nitroglycerin.

Acid reflux (heartburn), lung infection and lung inflammation can be confused with angina.

 

Assessment of Angina
 
 
Onset sudden
Provocation physical exertion, stress, cold weather, relieved by rest
Quality pressure or squeezing pain
Radiation pain can radiate to jaw, arm or upper back
Severity mild to moderate
Time relieved with rest and/or nitro within 3-5 min


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