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Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

Types of Angina

A. Effort-induced  most common form of angina and, therefore, is also called
typical angina pectoris.
angina, classic or  characterized by a short-lasting burning, heavy, or
stable angina. squeezing feeling in the chest.

 Classified between stable angina and myocardial
infarction.
 Chest pains occur with increased frequency, duration, and

.
intensity and are precipitated by progressively less effort
B. Unstable angina
 Any episode of rest angina longer than 20 minutes,
 any new onset of angina
,
,
 any increasing (crescendo) angina
 even sudden development of shortness of breath
.

 uncommon pattern of episodic angina that occurs at rest
➔ due to coronary artery spasm.
 Symptoms ➔ caused by ↓blood flow to the heart muscle

C. Prinzmetal, from the spasm of the coronary artery.

variant, vasospastic  Although individuals with this form of angina may have
significant coronary atherosclerosis, the angina attacks are
or rest-angina
unrelated to physical activity, heart rate, or blood

pressure.
 responds promptly to coronary vasodilators, such as

nitroglycerin and calcium-channel blockers.
 Patients with advanced coronary artery disease may present
D. Mixed forms of with angina episodes during effort as well as at rest,
angina suggesting the presence of a fixed obstruction associated

with endothelial dysfunction and vasospastic disease.
 an emergency ➔results from rupture of an atherosclerotic

plaque and partial or complete thrombosis of a coronary
artery.
 followed by platelet activation of the coagulation cascade
and vasoconstriction ➔ culminates in intraluminal

E. Acute coronary thrombosis and vascular occlusion.
syndrome  If the thrombus occludes most of the blood vessel ➔if the
occlusion is untreated ➔necrosis of the cardiac muscle may

ensue (myocardial infarction).
 Myocardial infarction (necrosis) is typified by increases in
the serum levels of biomarkers of myocardial necrosis

(AST, Troponin, Creatinine kinase).

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