Chronic coronary syndrome: Difference between revisions
(Created page with "Chronic ischaemic heart disease is referred to as '''chronic coronary syndrome''' (<abbr>CCS</abbr>) or stable ischaemic heart disease. These are chronic disorders caused by constant or recurring ischaemia of the heart, almost always due to coronary artery atherosclerosis. CCS includes the following disorders: * Effort angina/stable angina * CCS with “anginal equivalent” * Vasospastic angina/Prinzmetal angina * Silent ischaemia == Effort angina == Effort a...") |
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Chronic [[ischaemic heart disease]] is referred to as '''chronic coronary syndrome''' (<abbr>CCS</abbr>) or stable ischaemic heart disease. These are chronic disorders caused by constant or recurring ischaemia of the heart, almost always due to coronary artery [[atherosclerosis]]. | Chronic [[ischaemic heart disease]] is referred to as '''chronic coronary syndrome''' (<abbr>CCS</abbr>) or '''stable ischaemic heart disease'''. These are chronic disorders caused by constant or recurring ischaemia of the heart, almost always due to coronary artery [[atherosclerosis]]. | ||
CCS includes the following disorders: | CCS includes the following disorders: | ||
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* Vasospastic angina/Prinzmetal angina | * Vasospastic angina/Prinzmetal angina | ||
* Silent ischaemia | * Silent ischaemia | ||
Knowing the types of [[chest pain]] is important in the evaluation of CCS. | |||
== Effort angina == | == Effort angina == | ||
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Some patients with CCS never experience symptoms, called silent ischaemia. This is often due to [[diabetic neuropathy]], but not always. | Some patients with CCS never experience symptoms, called silent ischaemia. This is often due to [[diabetic neuropathy]], but not always. | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Internal Medicine (POTE course)]] | |||
Latest revision as of 12:16, 23 November 2023
Chronic ischaemic heart disease is referred to as chronic coronary syndrome (CCS) or stable ischaemic heart disease. These are chronic disorders caused by constant or recurring ischaemia of the heart, almost always due to coronary artery atherosclerosis.
CCS includes the following disorders:
- Effort angina/stable angina
- CCS with “anginal equivalent”
- Vasospastic angina/Prinzmetal angina
- Silent ischaemia
Knowing the types of chest pain is important in the evaluation of CCS.
Effort angina
Effort angina, also called stable angina, is the classical manifestation of CCS. It’s characterised by anginal pain which occurs predictably and reproducibly at a certain level of exertion and is relieved with rest or nitroglycerine. It occurs when the atherosclerotic stenosis reaches > 70% of the coronary artery lumen.
Anginal equivalents
Not all patients with CCS experience the typical anginal chest pain. Some experience so-called “anginal equivalents”, dyspnoea, nausea, sweating, or fatigue.
Vasospastic angina
Some patients with CCS experience spontaneous and transient symptoms (angina or anginal equivalent) in rest. This is called vasospastic angina or Prinzmetal angina and is due to coronary artery vasospasm, with or without underlying coronary artery disease.
ST elevation or depression is present during the pain episode. This may make it difficult to distinguish from ACS. Patients where ACS can’t be ruled out should be managed as ACS. Vasospasm can be diagnosed on angiography, and angiography is usually required to rule out ACS in these patients.
Silent ischaemia
Some patients with CCS never experience symptoms, called silent ischaemia. This is often due to diabetic neuropathy, but not always.