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Cardiology
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Stable angina: pain of cardiac origin, occurring on effort or with cold/stressful situations, relieved by rest; and stable over time. The pain is usually described as a tightness or band around the chest +/- radiates to the jaw or left arm.
The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Variant angina (Prinzmetal angina) is characterized by pain at rest and S-T segment elevation during an attack rather than depression; thus, it "varies" from typical angina pectoris. In some patients, variant angina seems to be related to occlusion of a single large vessel and vasospasm, although the condition is not always vasospastic or limited to involvement of a single vessel.
Cardio-vascular system (heart and circulation)
Published in David Sales, Medical IELTS, 2020
Sometimes patients will tell you that they have a history of a weak heart, which may encompass any cardiac diagnosis. Angina is a term that appears to be widely used and understood and may need investigation (tests) with an electrocardiograph (ECG) (heart tracing) or exercise test on a treadmill and venepuncture (blood tests) including lipids/cholesterol/triglycerides (types of fat).
What is the current value of beta-adrenoreceptor antagonists for angina?
Published in Expert Opinion on Pharmacotherapy, 2022
Jayakumar Sreenivasan, Urvashi Hooda, Wilbert S. Aronow
Beta-blockers are effective in reducing symptom burden and improving exercise capacity in patients with angina pectoris. The beta-blockers should be up titrated to a goal of low target heart rate to achieve the maximal clinical benefit. Most studies on beta-blockers for angina have demonstrated good clinical efficacy for symptom control. However, there is no substantial evidence to suggest a definitive mortality benefit unless used in the setting of recent myocardial infarction or heart failure with reduced ejection fraction. While angina, due to significant coronary artery disease or coronary microvascular dysfunction, is more common in women, they are under-represented in clinical trials. Similarly, the data on the safety and efficacy of beta-blockers in elderly adults with angina is limited. Observational studies have shown significant functional decline in elderly adults started on beta-blocker therapy despite the mortality benefit [28]. However, in elderly adults who have had a recent myocardial infarction or have concomitant systolic heart failure, the beta-blockers confer a true mortality benefit and should be considered as first-line agents. Clinicians should exercise caution and be mindful of the risk versus benefits in high-risk patient groups.
Angina due to coronary artery spasm (variant angina): diagnosis and intervention strategies
Published in Expert Review of Cardiovascular Therapy, 2021
Thanh Ha Nguyen, Gao-Jing Ong, Olivia C Girolamo, Viviane De Menezes Caceres’, Armin Muminovic, Yuliy Y Chirkov, John D Horowitz
Over the next 15 years, there were only occasional reports of ‘Prinzmetal’s variant angina’, but with the advent of diagnostic coronary angiography, it became increasingly obvious that some patients had no fixed obstructive coronary artery disease, but that in many cases, spontaneous spasm of one or more coronary arteries were observed during pain. A report by Oliva et al. [3] was typical of this development: spasm was observed, and it was noted that, although the clinical syndrome described by Prinzmetal [1] was quite common, only 14 cases of CAS had been documented previously. Thus, at this early stage, it was obvious that the definitive diagnosis of CAS involving the large coronary vessels was always going to present some difficulties, unless some diagnostic modality beyond routine coronary angiography became available. Indeed, the period between 1975 and 1978 saw a substantial increase in the utilization of intravenous ergonovine, an ergot alkaloid predominantly used in obstetrics, as a diagnostic test for CAS, via provocation of spasm [4].
Effects of cigarette smoking on older chinese men treated with clopidogrel monotherapy or aspirin monotherapy: a prospective study
Published in Platelets, 2020
Yulun Cai, Weihao Xu, Hongbin Liu, Fan Wang, Lei Duan, Huiying Li, Man Li, Yuerui Li, Lina Han, Hunan Xiao
Cardiovascular and cerebrovascular disease outcomes were evaluated for an average follow-up of 23 months. The primary endpoint was the composite of adverse clinical events, including death, myocardial infarction, stroke, transient ischemic attack (TIA), and unstable angina. Death was defined as death from all causes. Myocardial infarction was defined using the European Society of Cardiology/American College of Cardiology criteria [16]. Stroke was defined as an acute neurological vascular event lasting more than 24h. TIA was defined as an acute neurological vascular event lasting less than 24h. Unstable angina was defined according to the American College of Cardiology Foundation/American Heart Association criteria [17]. The follow-up was completed in all patients by reviewing their medical records and by telephone interviews. Emphasis was placed on the occurrence of the primary endpoint.