单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Stable,angina pectoris,（,SAP),Dept.of Geriatrics,Junling Huang,Stable angina pectorisDept.of,One night of winter,heavy dinner,Chest pain,lasted about 10 mimutes,What happened,？,One night of winterWhat ha,definition:,acute and transient myocardial ischemia and,anoxaemia,usually caused by,coronary insufficiency,during exertion,Characteristics:,paroxysmal squeezing-like chest pain,behind the mid sternum or,precordium,radiate to left shoulder and upper arm,precipitated by stress or exertion,relieve,rapidly,by rest or nitrates,Stable angina pectoris,definition:Stable angina pect,Oxygen,supply,Oxygen,demand,mechanism,OxygenOxygen mechanism,75%pts have significant,coronary lesion with diameter stenosis 70%,10%pts have left main disease,10-15%pts have,no significant stenosis,，,Ischemia may be related to coronary spasm or microvascular dysfunction.,Pathology,75%pts have significant coron,Typical and common,symptom,chest pain or oppression,Precipitation,Location and radiation,characteristics,duration,remission,Clinical manifestation,Typical and common symptomClin,Clinical manifestation,Precipitation,During,stress or exertion,other than after that,Clinical manifestationPrecipit,location,behind the mid sternum,no definite borderline,radiate to any dermatome from C8 to T4,most often to the left shoulder and upper arm,Atypical location:lower jaw,the back of neck,Clinical manifestation,neck,Behind the sternum,Inner upper,arm,Precordium,Below the xiphoid,location Clinical manifestatio,characteristics,tightness,squeezing,burning,pressing,choking,bursting,an ill-characterized discomfort,rarely sharply localized,not spasmodic,force the patient stop the activity till the symptom relieved,Clinical manifestation,characteristicsClinical manife,duration,Precipitated by exertion and promptly stops to rest,lasts less than 3mins,Following a heavy meal or brought on by anger,lasts,15-20mins,More than half an hour is unusual,can occur once a few days or several weeks,also several times a day,remission,Rapidly relieve after rest or using nitroglycerin,Clinical manifestation,durationClinical manifestation,Physical examination,increased HR,elevated BP,anxiety,occasionally a gallop rhythm,，,transient systolic murmur,Supraventricular or ventricular arrythmias(precipitating factor or a result),The signs of diseases may contribute to or accompany atherosclerotic heart disease,Clinical manifestation,Physical examinationClinical m,One night of winter,heavy dinner,Chest pain,lasted about 10 mimutes,What happened,？,One night of winterWhat ha,Diagnosis,Differentiation,Treatment,Laboratory,DiagnosisDifferentiationTreatm,Thank you,Thank you,