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Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
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Angina I: Introduction01:30

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Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
Angina III: Clinical Manifestations and Assessment01:29

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Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...

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24. Chronic refractory angina pectoris.

Maarten van Kleef1, Peter Staats, Nagy Mekhail

  • 1Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht, the Netherlands. maarten.van.kleef@mumc.nl

Pain Practice : the Official Journal of World Institute of Pain
|March 18, 2011
PubMed
Summary
This summary is machine-generated.

Spinal cord stimulation (SCS) offers relief for refractory angina pectoris, reducing pain and improving quality of life when other treatments fail. This therapy may also protect the heart muscle and is a viable option for selected patients.

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Area of Science:

  • Cardiology
  • Neurology
  • Pain Management

Background:

  • Refractory angina pectoris significantly reduces quality of life and life expectancy.
  • Optimal anti-anginal therapy and revascularization procedures (CABG, PTCA) may fail to resolve symptoms.
  • Spinal cord stimulation (SCS) is a potential treatment for patients with refractory angina.

Purpose of the Study:

  • To evaluate the efficacy and long-term outcomes of spinal cord stimulation (SCS) in patients with chronic refractory angina pectoris.
  • To investigate the potential mechanisms of action for SCS in managing cardiac pain.
  • To determine if SCS improves quality of life and reduces anginal attacks.

Main Methods:

  • Two prospective, randomized studies were conducted to assess SCS efficacy.
  • Patients included had refractory angina despite optimal medical therapy and attempted revascularization.
  • Long-term follow-up data on symptom improvement and quality of life were collected.

Main Results:

  • Spinal cord stimulation (SCS) resulted in reduced anginal attacks and improved rate pressure product.
  • Potential mechanisms include increased release of inhibitory neuropeptides and normalization of cardiac nerve activity.
  • Studies indicate SCS does not mask acute myocardial infarction.
  • Long-term results demonstrated significant improvements in symptoms and quality of life.

Conclusions:

  • Spinal cord stimulation (SCS) is an effective treatment for selected patients with chronic refractory angina pectoris.
  • SCS offers an alternative to surgical intervention and is viable when surgery is not possible.
  • The treatment improves symptoms, enhances quality of life, and may offer myocardial protection.