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    AY Unstable Angina Pectoris

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    aybatari
    This document presents a case report of a 44-year-old male patient admitted to the cardiology department with unstable angina pectoris (UAP). The patient reported a history of chest pain and tightness for the past few months. Physical examination and test results showed hypertension and signs of cardiac ischemia. The working diagnosis was UAP. The patient's management included oxygen supplementation, antiplatelet and anticoagulant medications, and treatment for hypertension. UAP is characterized by chest pain due to an imbalance in oxygen supply and demand in the heart. It occurs when unstable plaques rupture or thrombi form, partially blocking coronary arteries.

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    AY Unstable Angina Pectoris

    Uploaded by

    aybatari
    208 views24 pages
    This document presents a case report of a 44-year-old male patient admitted to the cardiology department with unstable angina pectoris (UAP). The patient reported a history of chest pain and tightness for the past few months. Physical examination and test results showed hypertension and signs of cardiac ischemia. The working diagnosis was UAP. The patient's management included oxygen supplementation, antiplatelet and anticoagulant medications, and treatment for hypertension. UAP is characterized by chest pain due to an imbalance in oxygen supply and demand in the heart. It occurs when unstable plaques rupture or thrombi form, partially blocking coronary arteries.

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    This document presents a case report of a 44-year-old male patient admitted to the cardiology department with unstable angina pectoris (UAP). The patient reported a history of chest pain and tightness for the past few months. Physical examination and test results showed hypertension and signs of cardiac ischemia. The working diagnosis was UAP. The patient's management included oxygen supplementation, antiplatelet and anticoagulant medications, and treatment for hypertension. UAP is characterized by chest pain due to an imbalance in oxygen supply and demand in the heart. It occurs when unstable plaques rupture or thrombi form, partially blocking coronary arteries.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    208 views24 pages

    AY Unstable Angina Pectoris

    Uploaded by

    aybatari
    This document presents a case report of a 44-year-old male patient admitted to the cardiology department with unstable angina pectoris (UAP). The patient reported a history of chest pain and tightness for the past few months. Physical examination and test results showed hypertension and signs of cardiac ischemia. The working diagnosis was UAP. The patient's management included oxygen supplementation, antiplatelet and anticoagulant medications, and treatment for hypertension. UAP is characterized by chest pain due to an imbalance in oxygen supply and demand in the heart. It occurs when unstable plaques rupture or thrombi form, partially blocking coronary arteries.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 24

    UNSTABLE

    ANGINA PECTORIS (UAP)

    Presented by:

    ANDI BATARI TOJA


    Supervisor :

    dr. Pendrik Tandean, Sp.PDKKV. FINASIM


    CARDIOLOGY DEPARTMENT
    MEDICAL FACULTY
    MAKASSAR
    2015

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    PATIENTS IDENTITY
    Name

    : Mr .H H

    Age

    : 44 years old

    Address

    : Makassar

    Medical record : 694703


    Date of admission

    : 21 january 2015

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    HISTORY TAKING
    Chief Complaint : Chest pain
    Structural anamnesis
    It was felt since 2 weeks ago and heavy in 2 hours
    before admitted to the hospital. The pain was felt in left
    chest, with the characteristic of pressure sensation. The
    pain didnt trigger by activity and not relief by rest. Pain
    was last more than 20 minutes. Chest pain
    accompanied by shortness of breath and sweating. The
    patient complaint about tightness while walking since 5
    months ago, which became worse, and it was not relief
    by rest. DOE (-) PND (-) orthopneu (-)

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    PAST MEDICAL HISTORY


    History of diabetes (-)
    History of hypertension (+) since 17 years old
    History of dyslipidemia (-)
    History of smoking (+)

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    RISK FACTORS
    Modifiable

    Unmodifiab
    le

    - Hypertension
    - Diabetes Mellitus

    - Gender : male
    - Age : 44 y.o
    - Family history

    PHYSICAL
    EXAMINATION

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    General Appearance :
    Moderate-illness /good
    nutrition/composmentis

    Vital Sign :
    BP : 140/80 mmHg
    Pulse : 100 x/minute, regular
    RR : 20 x/minute ;
    Temp : 36,7 C (per axilla)
    Head Examination :
    Eyes : anemia(-), icterus(-), cyanosis(-)
    Neck : JVP R+2 cmH20

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    Thoracic Examination :
    Inspection : Symmetric left and right
    Palpation : No mass, no tenderness
    Percussion : Sonor
    Auscultation : Breath Sound : vesicular,
    Rh -/- , wh -/-

    Cardiac Examination :
    Inspection : Ictus Cordis not visible
    Palpation : Ictus Cordis not palpable
    Percussion: Dull, normal limit
    Right Border : Linea parasternalis dextra
    Left Border: Linea midclavicularis sinistra
    Auscultation : Regular of I/II Heart Sound,
    murmur (-) gallop (-)

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    Abdominal Examination :
    Inspection : Convex, following breath
    Palpation

    unpalpable
    Percussion
    Auscultation
    normal

    Extremities :
    Oedema (-)

    movement
    : Liver and spleen

    : Tympani
    : Peristaltic sound (+),

    ECG Examination (21/1/2015)


    Rhythm

    : Sinus

    Heart Rate : 100 bpm


    Regularity : Reguler
    Axis

    : Normo Axis

    P Wave

    : Normal

    PR interval : 0,16
    QRS complex

    : Normal

    ST Segmen : Normal
    T wave

    : T Inverted
    on V2-V6, I, and AvL

    Conclusion

    : Sinus
    rhythm, HR 100
    bpm,Normo
    Axis,Whole Anterior

    LABORATORY FINDINGS (21-1-15)


    HEMATOLOGY

    VALUE

    REFERENCE

    UNIT

    VALUE
    WBC

    9,48

    4,00-10,0

    (10/UI)

    RBC

    4,19

    4,00-6,00

    (106/UI)

    HGB

    13,2

    12,0-16,0

    (gr/dL)

    HCT

    38,9

    37,0-48,0

    (%)

    PLT

    290

    150-400

    (103/uL)

    GDS

    120

    140

    Mg/dL

    Ureum

    37

    10-50

    Mg/dL

    Creatinin

    1,2

    <1,3

    Mg/dL

    SGOT

    16

    <38

    mmol/L

    SGPT

    12

    <41

    Mg/dL

    Total Cholesterol

    152

    200

    Mg/dL

    HDL Cholesterol

    55

    L(>55), P(>65)

    Mg/dL

    LDL Cholesterol

    114

    <130

    Mg/dL

    Trygliceride

    118

    200

    Mg/dL

    CK

    43

    L(<190),P(<167)

    U/L

    CKMB

    10,5

    <25

    U/L

    Troponin T

    0,02

    <0,05

    ---

    Natrium

    138

    136-145

    mmol

    Kalium

    4,2

    3,5-5,1

    mmol

    Chloride

    116

    97-111

    mmol

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    WORKING
    DIAGNOSIS
    Unstable Angina Pectoris

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    MANAGEMENT
    O22-4 LPM (via nasal kanul)
    Infus NaCl 0,9% 500ml/24 hours
    Anti Agregasi Platelet :
    Aspilet 80mg/24hours/oral
    Clopidogrel 75mg/24hours/oral

    Nitrat : Fasorbid 10mg/8hours/oral


    Anti coagulant : Arixtra 2,5 mg/24hours/subkutan
    Anti hipertensi : ACE-I : Captopril 25mg/8 hours/oral
    Laxadine syrup 10 ml/24 hours
    Anti ansietas : Alprazolam 0.5 mg/24 hours/oral

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    DISCUSSION

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    DEFINITION
    Angina
    pectoris
    is
    a
    syndrome
    characterized by chest pain resulting from
    an imbalance between O2 supply & demand,
    and is most commonly caused by the
    inability of atherosclerotic coronary arteries
    to perfuse the heart under conditions of
    increased myocardial O2 consumption.

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    CLASSIFICATION

    Based
    on
    CANADIAN
    CARDIOVASCULAR
    SOCIETY FUNCTIONAL CLASSIFICATION

    CLASS I

    No angina with ordinary activity.


    Angina with strenuous, rapid or prolonged
    exertion.

    CLASS II Slight limitation of ordinary


    activity ; angina when walking up stairs
    briskly, or walking on a cold or windy day.

    CLASS III Marked limitation ; angina when


    walking at normal pace up flight of stairs, or
    walking 1-2 blocks distance.

    CLASS IV Angina on minimal exertion or at


    rest.

    ETIOLOGY

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    Plaque rupture
    Thrombus formation
    Vasospasme of coronary
    artery

    Cardiology, Desmond G. Julian, J.Campbell Cowan, James M.


    McLenachan, 8th edition, Elsevier, 2005

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    UAP
    If the plaque become unstable caused by
    bleeding, rupture, or fissure and result in
    thrombus formation which blocked the
    vascularisation, angina may occur. Angina
    become progressive crescendo and have
    no relation to activity. Moreover, angina
    can occur anytime, even resting time.
    This kind of angina called by the
    Unstable Angina Pectoris

    CLINICAL
    MANIFESTATIONS
    Substernal chest pain / chest discomfort radiated to the left
    arm, shoulder, neck, jaw. Penetrated to the back.
    The chest discomfort may also be described as a dull pain,
    pressure, squeezing or crushing sensation or burning
    sensation
    Duration more than 20 minutes. More intense and persistent

    Not fully relieved by rest or nitroglycerine

    Often accompanied by systemic symptoms: nausea, vomiting,


    palpitation, fatigue, cold sweat, light headness

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    CORONARY ARTERY DISEASE


    UAP

    CAD

    ACS

    NSTEMI

    Stable
    Angina
    Pectoris

    STEMI

    DIAGNOSIS

    Oxford Handbook of Clinical Medicine 6th


    Edition

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    Unstable Angina
    Therapeutic Goals
    Treatment for unstable angina focuses on three
    goals:
    Stabilizing any plaques that may have
    ruptured in order to prevent a heart attack,
    Relieving symptoms
    Treating the underlying coronary artery
    disease (CAD).

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    MANAGEMENT

    http://www.cardiosmart.org/HeartDisease

    UAP - CASE REPORT


    CARDIOLOGY DEPARTMENT

    THANK YOU

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