1、Stable angina pectoris（SAP)Dept.of GeriatricsJunling Huang One night of winterheavy dinnerChest pain lasted about 10 mimutesWhat happened？definition:acute and transient myocardial ischemia and anoxaemia usually caused by coronary insufficiency during exertionCharacteristics:paroxysmal squeezing-like
2、 chest pain,behind the mid sternum or precordiumradiate to left shoulder and upper armprecipitated by stress or exertionrelieve rapidly by rest or nitrates Stable angina pectorisOxygen supplyOxygen demandmechanism75%pts have significant coronary lesion with diameter stenosis 70%10%pts have left main
3、 disease10-15%pts have no significant stenosis，Ischemia may be related to coronary spasm or microvascular dysfunction.PathologyTypical and common symptom chest pain or oppression Precipitation Location and radiation characteristics duration remissionClinical manifestationClinical manifestationPrecip
4、itation During stress or exertion,other than after thatlocation behind the mid sternum no definite borderlineradiate to any dermatome from C8 to T4,most often to the left shoulder and upper armAtypical location:lower jaw,the back of neckClinical manifestationneckBehind the sternumInner upperarmPreco
5、rdium Below the xiphoidcharacteristicstightness,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 manifestationdurationPrecipitated by exertion and promptly stops t
6、o rest,lasts less than 3minsFollowing a heavy meal or brought on by anger,lasts15-20minsMore than half an hour is unusualcan occur once a few days or several weeks,also several times a dayremission Rapidly relieve after rest or using nitroglycerin Clinical manifestationPhysical examinationincreased
7、HR,elevated BP anxietyoccasionally a gallop rhythm，transient systolic murmurSupraventricular or ventricular arrythmias(precipitating factor or a result)The signs of diseases may contribute to or accompany atherosclerotic heart diseaseClinical manifestation One night of winterheavy dinnerChest pain lasted about 10 mimutesWhat happened？DiagnosisDifferentiationTreatmentLaboratoryThank you
