3.2 days

MEDICAL: Angina pectoris 124

4.2 days

MEDICAL: Circulatory Disorders, Except AMI, W Card Cath, and Complex

An ngina pectoris is a symptom of ischemic heart disease that is characterized by paroxysmal and usually recurring substernal or precordial chest pain or discomfort. More than 6 million Americans experience angina, and approximately 350,000 new cases of angina occur every year. Angina pectoris is caused by varying combinations of increased myocardial demand and decreased myocardial perfusion. The imbalance between supply and demand is caused either by a primary decrease in coronary blood flow or by a disproportionate increase in myocardial oxygen requirements. Blood flow through the coronary arteries is partially or completely obstructed because of coronary artery spasm, fixed stenosing plaques, disrupted plaques, thrombosis, platelet aggregation, and embolization.

Angina can be classified as chronic exertional (stable, typical) angina, variant angina (Prinzmetal's), unstable or crescendo angina, or silent ischemia (Table 8). Chronic exertional angina is usually caused by obstructive coronary artery disease that causes the heart to be vulnerable to further ischemia whenever there is increased demand or workload. Variant angina may occur in people with normal coronary arteries who have cyclically recurring angina at rest, unrelated to effort. Unstable angina is diagnosed in patients who report a changing character,

• TABLE 8 Classification of Angina Pectoris
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