Precipitating factors of Angina

      • Precipitating factors of Angina
        • Physical Exertion
          • Increases HR, reducing the time the heart spends in diastole (the time of greatest coronary blood low), resulting in an increase in myocardial O2 demand.
          • Isometric exercise of the arms (e.g., raking, lifting heavy objects, snow shoveling) can cause exertional angina.
        • Temperature Extremes
          • Increase the workload of the heart.
          • Blood vessels constrict in response to a cold stimulus.
          • Blood vessels dilate and blood pools in the skin in response to a hot stimulus.
        • Strong Emotions
          • Stimulate the sympathetic nervous system, activating the stress response.
          • Increase the workload of the heart.
        • Consumption of Heavy Meal (e.g., holiday meals)
          • Can increase the workload of the heart.
          • During the digestive process, blood is diverted to the GI system, reducing blood low in the coronary arteries.
        • Tobacco Use and Environmental Tobacco Smoke
          • Diminish available O2 by increasing the level of carbon monoxide.
          • Nicotine stimulates catecholamine release, causing vasoconstriction and an increased HR.
        • Sexual Activity
          • Increases the cardiac workload and sympathetic stimulation.
          • In a person with CAD, the extra cardiac workload may precipitate angina.
        • Stimulants (e.g., cocaine, amphetamines)
          • Increase HR and BP and subsequently increases myocardial O2 demand.
          • Stimulate vasoconstriction and subsequently decreases myocardial O2 supply.
          • May precipitate dysrhythmias
        • Circadian Rhythm Patterns
          • Manifestations of CAD tend to occur in the early morning after awakening.