Wednesday, April 26, 2017

Clinical Features Of Patients Presenting With Angina

Angina is defined as a condition in which patient suffers from chest pain due to decreased blood supply to the cardiac muscles. Most common cause is obstruction or spasm of coronary arteries.

Clinical Presentation
Diagnosis is usually made on clinical history. Patients with stable angina present with:

Pain: Episodic central-crushing or band like chest pain that may radiate to jaw/ neck or one/both arms. Pain in the arm/ neck may be the only symptom. It is important to ask about the frequency, severity, duration and timings of the pain.

Precipitating/ Relieving Factors: Angina pain is usually precipitated by exertion, cold, emotion, and/or heavy meals. Pain stops with rest or using glyceral trinitrate.

Associated Symptoms:  May be associated with palpitations, sweating, nausea and /or breathlessness during attacks.

Presence of risk factors: Patients who suffer from angina have certain risk factors like smoking, family history of cardiac disease, history of other vascular disease.

Physical examination
There are usually no physical signs although anemia may exacerbate symptoms. It is important to check BMI and BP. Look for murmurs especially ejection systolic murmur of aortic stenosis and any evidence of peripheral vascular disease and carotid bruits ( esp in diabetes).

12 lead resting ECG provides information on rhythm, presence of heart block, previous MI, myocardial hypertrophy and /or ischemia.

A normal ECG does not exclude coronary artery disease but an abnormal ECG identifies those at higher risk of cardiac events.

No comments:

Post a Comment