Angina is a symptom complex resulting from mismatch of myocardial oxygen demand and supply.
Classic angina is a sense of pressure or heaviness deep to the precordium, usually brought on by exertion or anxiety and relieved by rest.
Anginal equivalent is characterized by exertional dyspnea or exertional fatigue which results from myocardial ischemia and is relieved by rest or nitroglycerin.
Variant angina, also referred to as Prinzmetal's angina, describes angina occurring at rest of in typical patterns such as after exercise or nocturnally. Prinzmetal's angina is caused by coronary artery spasm and is associated with ECG changes (usually ST elevation) during symptoms.
Unstable angina is characterized by pain which is new or which is changed in character to become more frequent, more severe or both. Unstable angina portends myocardial infarction in a certain percentage of patients.
Causes of angina include: atherosclerosis of the coronary arteries; Coronary artery spasm; Thrombosis; Aortic stenosis; Hypertrophic cardiomyopathy; Primary pulmonary hypertension; Severe hypertension; and Aortic insufficiency
Risk factors include: Family history of premature coronary artery disease (CAD); Hypercholesterolemia; Hypertension; Tobacco abuse; Diabetes mellitus; Male gender; and Advanced age.
Standard cardiovascular lab tests include Total cholesterol, and HDL and LDL cholesterol. An ECG may show evidence of prior myocardial infarction.
Additional tests include Exercise stress testing; Radionuclide scintigraphy; Stress echocardiography; and Coronary angiography.
Specialty Lab Tests
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