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Related Concept Videos

Angina II: Classification01:27

Angina II: Classification

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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 IV: Management01:26

Angina IV: Management

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IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
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Angina I: Introduction01:30

Angina I: Introduction

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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...
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Angina V: Nursing Management01:20

Angina V: Nursing Management

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Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
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Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

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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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Antianginal Drugs: Calcium Channel Blockers and Ranolazine01:25

Antianginal Drugs: Calcium Channel Blockers and Ranolazine

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Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
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Refractory Angina-Unsolved Problem.

Marcin Makowski1, Joanna Samanta Makowska2, Marzenna Zielińska1

  • 1Department of Interventional Cardiology, Medical University of Lodz, Central Clinical Hospital, ul. Pomorska 251, Lodz 92-213, Poland.

Cardiology Clinics
|October 10, 2020
PubMed
Summary
This summary is machine-generated.

Refractory angina, persistent chest pain despite treatment, is increasingly common. New therapeutic options are emerging, but more clinical trials are needed to guide treatment for this challenging condition.

Keywords:
Coronary sinus reducerEnhanced external counter-pulsationNeuromodulationRefractory angina pectorisSpinal cord stimulation

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Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Refractory angina involves persistent chest pain (≥3 months) from coronary artery disease unresponsive to standard treatments.
  • The incidence of refractory angina is rising due to an aging population and improved cardiovascular care.
  • Current treatment options are expanding, yet evidence-based guidelines are lacking.

Purpose of the Study:

  • To review current pharmacologic and interventional therapeutic strategies for refractory angina.
  • To highlight the growing clinical need for effective management of this condition.
  • To identify the gap in high-quality clinical evidence for treatment recommendations.

Main Methods:

  • Literature review of pharmacologic and interventional treatments for refractory angina.
  • Analysis of the current therapeutic landscape and treatment challenges.
  • Identification of research gaps and the need for randomized clinical trials.

Main Results:

  • Several pharmacologic and interventional options exist for refractory angina.
  • The condition is becoming more prevalent in clinical practice.
  • A significant lack of robust randomized clinical trial data hinders evidence-based recommendations.

Conclusions:

  • Effective management of refractory angina requires a comprehensive approach.
  • Further research, particularly large-scale randomized trials, is crucial.
  • Developing clear treatment guidelines is essential for improving patient outcomes.