Lecture Notes on Angina

Introduction to Angina

Coronary arteries supply blood to the heart.
- Originate from the aorta.
- Two main coronary arteries: Left and Right.
Left Coronary Artery
- Feeds the left atrium, left ventricle, and interventricular septum.
- Branches into left anterior descending artery and left circumflex.
Right Coronary Artery
- Feeds the right atrium, right ventricle, part of the left ventricle, and electrical nodes (SA and AV nodes).

Stable Angina
- Also known as exertional angina.
- Caused by physical or emotional exertion.
- Characterized by a stable fatty plaque in coronary arteries.
- Predictable and short-lived (15 minutes or less).
- Relieved by rest or nitroglycerin.
Unstable Angina
- Also called pre-infarction angina.
- Occurs without exertion and can happen at rest.
- Caused by rupture of a fatty plaque leading to a thrombus (clot).
- Unpredictable, longer-lasting, and not relieved by rest or nitroglycerin.
- May lead to myocardial infarction.
Variant Angina (Prinzmetal Angina)
- Caused by a vasospasm of a coronary artery.
- Occurs at rest, often at night or in the morning.
- Associated with the use of drugs like cocaine or alcohol.
- Treated with nitroglycerin or calcium channel blockers.

Nitroglycerin
- A vasodilator that helps relieve chest pain by opening blood vessels.
- Administered under the tongue or as a spray.
- Educate patients on dosage and seeking medical attention if pain persists.
Medications
- Statins, beta blockers, calcium channel blockers, ACE inhibitors, ARBs.
- Antiplatelet therapy with aspirin to prevent clot formation.
Lifestyle Changes
- Low-fat, low-sodium diet, quitting smoking, managing diabetes.

Troponin levels: Negative in stable/unstable angina but can indicate heart muscle damage.
ECG Changes: ST depression/inversion in stable angina; possible elevation in variant angina.