稳定型心绞痛英文学案.ppt

Stable angina pectoris （SAP) Dept. of Geriatrics Junling Huang One night of winter heavy dinner Chest pain lasted about 10 mimutes What happened？ 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 Stable angina pectoris Oxygen supply Oxygen demand mechanism 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. Pathology Typical and common symptom chest pain or oppression Precipitation Location and radiation characteristics duration remission Clinical manifestation Clinical manifestation Precipitation During stress or exertion, other than after that 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 Clinical manifestation neck Behind the sternum Inner upper arm Precordium Below the xiphoid 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 Clinical manifestation 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 Clinical manifestation Physical examination increased HR, eleva