稳定型心绞痛 英文.ppt

Stable angina pectoris （SAP) ; One night of winter heavy dinner Chest pain lasted about 10 mimutes ;definition: acute and transient myocardial ischemia and anoxaemia usually caused by coronary insufficiency during exertion Characteristics: paroxysmal squeezing-like chest pain, behind the mid sternum or precordium radiate to left shoulder and upper arm precipitated by stress or exertion relieve rapidly by rest or nitrates ;Oxygen supply;75% pts have significant coronary lesion with diameter stenosis 70% 10% pts have left main disease 10-15% pts have no significant stenosis， Ischemia may be related to coronary spasm or microvascular dysfunction. ;Typical and common symptom chest pain or oppression Precipitation Location and radiation characteristics duration remission ;Clinical manifestation;location behind the mid sternum no definite borderline radiate to any dermatome from C8 to T4, most often to the left shoulder and upper arm Atypical location: lower jaw, the back of neck;characteristics tightness, squeezing, burning, pressing, choking, bursting,an ill-characterized discomfort rarely sharply localized, not spasmodic force the patient stop the activity till the symptom relieved ;duration Precipitated by exertion and promptly stops to rest, lasts less than 3mins Following a heavy meal or brought on by anger, lasts 15-20mins More than half an hour is unusual can occur once a few days or several weeks, also several times a day remission Rapidly relieve after rest or using nitroglycerin ;Physical examination increased HR, elevated BP anxiety occasionally a gallop rhythm，transient systolic murmur Supraventricular or ventricular arrythmias (precipitating factor or a result) The signs of diseases may contribute to or accompany atherosclerotic heart disease; One night of winter heavy dinner Chest pain lasted about 10 mimutes ;Diagnosis;Thank you