Cardiovascular

Stable Angina

Stable angina is predictable myocardial ischaemic pain from supply-demand mismatch, usually due to atherosclerotic coronary disease; new, worsening or rest pain is an ACS emergency until assessed.

Definition

Stable angina is transient myocardial ischaemia caused by an imbalance between myocardial oxygen demand and coronary blood supply, usually from fixed atherosclerotic coronary disease, producing predictable symptoms with exertion or stress.

First principles

Fixed coronary obstruction limits flow reserve

At rest, coronary flow may be adequate despite a stenosis. During exertion or stress, myocardial oxygen demand rises but flow cannot increase sufficiently, producing transient ischaemia and predictable symptoms.

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