Angina-like symptoms

TABLE 4-1. Non-atherosclerotic Conditions that Can Cause Angina-like Symptoms ... 

Palytoxin is a complex marine natural product containing 71 stereochemical elements (Fig. 5). The structure of PTX was elucidated by Moore. PTX is isolated from a zoanthid (order Zoanthidea) a type of soft coral commonly found in coral reefs all around the world. These animals come in a variety of different colonizing formations and in numerous colors. They can be found as individual polyps, attached by a fleshy stolon or a mat that can be created from pieces of sediment, sand and rock (soft coral). PTX is considered to be one of the most toxic nonpeptide substances known, second only to Maitotoxin. Typical symptoms of palytoxin poisoning are angina-like chest pains, asthma-like breathing difficulties, tachycardia, unstable blood pressure, hemolysis (destruction of red blood... 

Angina pectoris, depression, and flu-like symptoms occur rarely. 

HEALTH SYMPTOMS inhalation (loss of hair on the body and head, severe pains in the legs and loins, chest pain, abdominal pain, nausea, vomiting, diarrhea, dry skin) skin contact (industrial poisoning has been reported to cause hair discoloration, which later falls out) ingestion (loss of vision, polyneuritis, psychic disturbances, delirium, convulsions, respiratory paralysis, angina-like pains, coma). 

The predominant symptom of ACS is midline anterior chest discomfort (most often occurring at rest), severe new-onset angina, or increasing angina that lasts at least 20 minutes. The discomfort may radiate to the shoulder, down the left arm, to the back, or to the jaw. Accompanying symptoms may include nausea, vomiting, diaphoresis, or shortness of breath. Elderly patients, patients with diabetes, and women are less likely to present with classic symptoms. 

When angina occurs more frequently than once a day, chronic prophylactic therapy should be instituted. 8-Blockers may be preferable because of less frequent dosing and other desirable properties (e.g., potential cardioprotective effects, antiarrhythmic effects, lack of tolerance, antihypertensive efficacy). The appropriate dose should be determined by the goals outlined for HR and DP. An agent should be selected that is well tolerated by individual patients at a reasonable cost. Patients most likely to respond well to 8-blockade are those with a high resting HR and those with a relatively fixed anginal threshold (i.e., their symptoms appear at the same level of exercise or workload on a consistent basis). 

In 41 patients with Parkinson s disease who took pergolide, confusion and hallucinations were the adverse effects that were most likely to result in withdrawal of pergolide (2). Symptoms suggestive of dose-related angina pectoris occurred in four patients in the open phase and two patients in the earlier double-blind phase these symptoms were easily controlled by dosage reduction or withdrawal of pergolide without sequelae. There was leukopenia in one patient. 

Anemia of rapid onset is most likely to present with cardiorespiratory symptoms snch as tachycardia, palpitations, angina, hypotension, fight-headedness, and breathlessness dne to decreased oxygen delivery to tissues or from hypovolemia in those with acnte bleeding. With severe intravascnlar blood volnme loss, peripheral vasoconstriction and central vasodilation preserve blood flow to vital organs. Over time systemic small vessel dilation increases tissne oxygenation. Vascular compensation resnlts in decreased systemic vascnlar resistance, increased cardiac ontpnt, and tachycardia. With acnte hemolysis and fall in RBC mass, there is some decrease in blood volnme, bnt not in plasma volume. 

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