Page 15 - Clinical Pearls in Cardiology

History and General Examination 3

It is associated with transient ST segment elevation in
the electrocardiogram. Calcium antagonists and nitrates
are useful.
5. What are angina equivalents?
Angina equivalents are symptoms of myocardial
ischemia other than the usual chest pain that is typical
of angina. They are more common in the elderly, females
and in diabetic patients. These symptoms include the
following:
Angina equivalents
• Dyspnea
• Nausea
• Fatigue
• Faintness.
6. What is ‘angor animi’?
‘Angor animi’ is a sense of impending doom or death.
This peculiar type of facial expression is sometimes
found in patients with acute onset of chest pain due to
serious conditions like myocardial infarction (also seen
in pheochromocytoma).
7. What are the important causes that can cause angina
in the absence of coronary atherosclerosis?
The important causes that can cause angina in the
absence of coronary atherosclerosis are the following:
1. Valvular heart diseases like aortic stenosis and aortic
regurgitation, pulmonary hypertension, hypertrophic
cardiomyopathy
2. Coronary embolism, coronary arteritis, coronary AV
fistula.
The first three conditions are associated with gross
hypertrophy of the myocardium, which results in
increased myocardial oxygen demand. When the normal