Angina Pectoris

MODIFIABLE FACTORS NON MODIFIABLE FACTORS

 High cholesterol diet  Age
 Obesity  Gender
 Cigarette smoking  Family history
 Sedentary lifestyle

Formation of thrombus

Presence of atherosclerosis

Eating heavy meals Exposure to cold, Physical

emotional stress, exertion
smoking
 Blood flow in the
mesenteric region  Myocardial 02
Vasoconstriction
demand

Reduced coronary tissue perfusion

↓myocardial oxygenation

 O2 demand
Aerobic metabolism

HR accelerates
 Lactic acid ↓ ATP

↓ Cardiac contraction Myocardium Vent. filling

Lactic acidosis becomes ischemic time
strength

Chest pain
Depression of Vent. perform ↓SV
vent. function deteriorates
Auto regulation of
blood flow or LV diastole
compensation ↓SV pressure rise

 In diameter of blood Change in systemic BP Pulmonary

vessels and arteries congestion dyspnea
 Angina Pectoris

If compensatory
mechanism fails

Prolonged ischemia and

myocardium

Myocardial infarction

↓ myocardial ↓SV ↓ ejection Altered vent.

contractility traction Compliance

Decreased cardiac output

Decreased perfusion

Stimulate the renin angiotensin aldosterone

system

Stimulation of CNS

Release of epinephrine and norepinephrine

 Heart rate

If compensatory mechanism fails

Complications such as:

 Dysrithmia
 Cardiogenic shock