Angina risk factors

Classic risk factors of atherosclerosis must first and foremost be fought with lifestyle interventions such as diet, physical activity, and smoking cessation. Indeed, and although it effectively relieves angina, simply... 

Moderate risk Has three or more risk factors for coronary artery disease Has moderate, stable angina Had a recent myocardial infarction or stroke within the past 6 weeks Has moderate congestive heart failure (NYHA Class 2) Fbtient should undergo a complete cardiovascular work-up and treadmill stress testing to determine tolerance to increased myocardial energy consumption associated with increased sexual activity... 

The response-to-injury hypothesis states that risk factors such as oxidized LDL, mechanical injury to the endothelium, excessive homocysteine, immunologic attack, or infection-induced changes in endothelial and intimal function lead to endothelial dysfunction and a series of cellular interactions that culminate in atherosclerosis. The eventual clinical outcomes may include angina, myocardial infarction, arrhythmias, stroke, peripheral arterial disease, abdominal aortic aneurysm, and sudden death. 

Exercise tolerance (stress) testing (ETT) is recommended for patients with an intermediate probability of CAD. Results correlate well with the likelihood of progressing to angina, occurrence of acute MI, and cardiovascular death. Ischemic ST-segment depression during ETT is an independent risk factor for cardiovascular events and mortality. Thallium myocardial perfusion scintigraphy may be used in conjunction with ETT to detect reversible and irreversible defects in blood flow to the myocardium. 

Low risk Has asymptomatic cardiovascular disease with <3 risk factors for cardiovascular disease Has well-controlled hypertension Has mild, stable angina Has mild congestive heart failure (NYHA class 1) Has mild valvular heart disease Had a myocardial infarction >6 weeks ago Patient can be started on phosphodiesterase inhibitor... 

Antihypertensive Agents. Hypertension (high blood pressure) is a significant risk factor for cardiovascular diseases such as angina heart attacks, and strokes. /(-Adrenoceptor (adrenergic nervous system receptors of the /(-type) antagonists (/(-blockers), calcium channel blockers, angiotensinconverting enzyme (ACE) inhibitors, and potassium channel activators... 

Sildenafil was the first oral treatment for ED and is the most extensively evaluated (35). Overall success rates in patients with cardiovascular disease of 80% or greater have been recorded with no evidence of tolerance, Patients with diabetes with or without additional risk factors, with their more complex, and extensive pathophysiology, have an average success rate of 60%. In randomized trials to date, open-label or outpatient monitoring studies the use of sildenafil is not associated with any excess risk of myocardial infarction, stroke, or mortality (38-40), In patients with stable angina pectoris there is no evidence of an ischemic effect due to coronary steal, and in one large, double-blind, placebo-controlled, exercise study sildenafil 100 mg increased exercise time and diminished ischemia (41), A study of the hemodynamic effects in men with severe CAD identified no adverse cardiovascular effects and a potentially beneficial effect on coronary blood flow reserve (42), Studies in patients with and without diabetes have demonstrated improved endothelial function acutely and after long-term oral dose administration, which may have implications beyond... 

Modifiable risk factors (those that we can do something about) for angina and ischaemic heart disease include ... 

A 46-year-old man developed a Q-wave inferior and a right ventricular myocardial infarct with postinfarction angina after the third cycle of vincristine -I- doxorubicin for multiple myeloma. The patient had no risk factors for ischemic heart disease, except for a positive smoking history, nor for hyperviscosity (24). 

The incidence of cardiovascular disease is sevenfold to tenfold greater in patients with CKD than in non-CKD age-and seX matched controls. By the time patients develop the need for RRT there is an approximately 17 times greater risk of cardiovascular death or nonfatal myocardial infarction than age-matched and sex-matched individuals without kidney disease.The spectrum of cardiovascular disease studied in CKD includes (1) angina, (2) congestive heart failure, (3) myocardial infarction, (4) peripheral vascular disease, (5) stroke, and (6) transient ischemic attack. Structural heart disease, such as left ventricular hypertrophy (LVH) and valvular heart disease, is a very common sequela to CKD. Up to 75% of patients commencing dialysis have echocardiographic evidence of The risk factors for... 

Dipyridamole testing has been shown to be safe and effective in the elderly and in those with unstable angina immediately after MI (within days). It also may be used to assess the status of revascularization procedures. As a prognostic test, dipyridamole testing is very useful. In several studies, abnormal scans have shown about a 10-fold increase in event rates over 1 to 2 years of follow-up. Abnormal scans also have been shown to be an independent risk factor for myocardial infarction and death with a relative risk of 3.1. Reversible defects correlate best with events, with one study demonstrating a 4.41 relative risk for cardiac events. 

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