Classification of Angina and Management Strategies
1. Stable Angina
Definition: Characterized by predictable episodes of chest pain or discomfort that occur with exertion or emotional stress and are relieved by rest or nitroglycerin.
Management:
- Lifestyle Modifications: Smoking cessation, dietary changes, and regular exercise.
- Medications: Nitrates, beta-blockers, calcium channel blockers, antiplatelet agents, and statins.
2. Unstable Angina
Definition: Characterized by episodes of angina that occur at rest or with minimal exertion and may signal an impending myocardial infarction.
Management:
- Immediate Medical Attention: Hospitalization and continuous monitoring.
- Medications: Antiplatelet therapy, nitrates, beta-blockers, and anticoagulants.
- Revascularization: Consideration for coronary angioplasty or CABG.
3. Variant Angina (Prinzmetal's Angina)
Definition: Characterized by episodes of angina caused by coronary artery spasm, typically occurring at rest.
Management:
- Medications: Calcium channel blockers, long-acting nitrates.
- Avoidance of Triggers: Stress management and avoiding stimulants.
4. Microvascular Angina
Definition: Angina due to dysfunction of the small coronary blood vessels despite normal epicardial coronary arteries.
Management:
- Medications: Nitrates and beta-blockers.
- Cardiac Rehabilitation: Structured exercise programs and lifestyle modifications.
Summary
The management of angina varies based on its type, severity, and underlying mechanisms. Continuous monitoring and follow-up are crucial to managing angina effectively and preventing complications.
