Smoking

Hypertension

DM II

Obesity

Vasoconstriction

Pancreas produces less amount of the hormone insulin

HDL

LDL

Blood Viscosity

Slower blood flow

Fatty lipids deposits in coronary arterial wall

Statins

Release of T-lymphocytes and monocytes

Smooth muscle cells proliferate to form a fibrous cap

Aspirin

Arteriogram

Plaques protrude to the arterial lumen

Beta-blockers Nitroglycerin

Narrowing/obstruction of blood flow

Decreased coronary tissue perfusion

Myocardial Ischemia

Anaerobic metabolism

Lactic acid production

Chestpain due to lactic acid accumulation

ANGINA PECTORIS

Stable Angina

Unstable Angina

Variant/Prizmetals

Nocturnal Angina

y Chest pain y Palpitation y Back, arm or neck pain y Fatigue y SOB - episodes occur in a pattern and predictable. Pain usually lasts less than 5 min.

y Sudden chest pain y Choking y SOB y Crushing, burning sensation - symptoms are unpredictable and often occur at rest. Pain usually last more than 15 minutes.

y pressure like pain in chest, shoulder, jaw, neck, back, arms.

y REM (rapid eye movement) y Chest pain (occurs when sleeping)