Clinical manifestation of CAD : Angina

  • Clinical manifestation of CAD
    • Angina
      • Chronic and progressive disease
        • O2 demand > O2 supply → myocardial ischemia
        • Angina = clinical manifestation
          • Occurs when arteries are blocked 70% or more
          • 50% or more for left main coronary artery
      • Locations and patterns of Angina
        • Mid sternum, left shoulder and down both arms, neck and arms
        • Substernal radiating to neck and jaw and substernal radiating down left arm
        • Epigastric and radiating to neck, jaw, and arms
        • Intrascapular
      • PQRST Assessment of Angina

Factor

Questions to ask the patient

P

Precipitating events

What events or activities precipitated the pain or discomfort (e.g., argument, exercise, resting)?

Q

Quality of pain

What does the pain or discomfort feel like (e.g., pressure, dull, aching, tight, squeezing, heaviness)?

R

Region (location) and radiation of pain

Can you point to where the pain or discomfort is located? Does the pain or discomfort radiate to other areas (e.g., back, neck, arms, jaw, shoulder, and elbow)?

S

Severity of pain

On a scale of 0 to 10, with 0 indicating no pain and 10 being the most severe pain you could imagine, what number would you give the pain or discomfort?

T

Timing

When did the pain or discomfort begin? Has it changed since this time? Have you had pain/discomfort like this before?