1. Angina and MI

2. What Is Angina?
Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn't get enough oxygen-rich blood.
Angina may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion.

3. Angina isn't a disease; it's a symptom of an underlying heart problem
Angina isn't a disease; it's a symptom of an underlying heart problem. Angina usually is a symptom of coronary heart disease (CHD).
CHD is the most common type of heart disease in adults. It occurs if a waxy substance called plaque (plak) builds up on the inner walls of your coronary arteries. These arteries carry oxygen-rich blood to your heart.

4. Types of Angina Stable Angina Unstable Angina
Variant (Prinzmetal's) Angina

5. How Is Angina Treated?
Treatments for angina include lifestyle changes, medicines, medical procedures, cardiac rehabilitation , and other therapies. The main goals of treatment are to:
Reduce pain and discomfort and how often it occurs
Prevent or lower your risk for heart attack and death by treating your underlying heart condition

6. Lifestyle changes and medicines may be the only treatments needed if your symptoms are mild and aren't getting worse. If lifestyle changes and medicines don't control angina, you may need medical procedures or cardiac rehab.
Unstable angina is an emergency condition that requires treatment in a hospital.

7. Medicines
Nitrates are the medicines most commonly used to treat angina. They relax and widen blood vessels. This allows more blood to flow to the heart, while reducing the heart’s workload.
Nitroglycerin is the most commonly used nitrate for angina. Nitroglycerin that dissolves under your tongue or between your cheek and gum is used to relieve angina episodes.

8. Nitroglycerin pills and skin patches are used to prevent angina episodes. However, pills and skin patches act too slowly to relieve pain during an angina attack.
Other medicines also are used to treat angina, such as beta blockers, calcium channel blockers, ACE inhibitors, oral antiplatelet medicines, or anticoagulants (blood thinners). These medicines can help:
Lower blood pressure and cholesterol levels
Slow the heart rate
Relax blood vessels
Reduce strain on the heart
Prevent blood clots from forming

9. heart attack
A heart attack occurs when blood flow to a part of your heart is blocked for a long enough time that part of the heart muscle is damaged or dies. The medical term for this is myocardial infarction.

10. Treatment
In the emergency room:
You will be hooked up to a heart monitor, so the health care team can look at how your heart is beating.
You will receive oxygen so that your heart doesn't have to work as hard.
An intravenous line (IV) will be placed into one of your veins. Medicines and fluids pass through this IV.
You may get nitroglycerin and morphine to help reduce chest pain.
You may receive aspirin, unless it would not be safe for you. In that case, you will be given another medicine that prevents blood clots.
Dangerous abnormal heartbeats (arrhythmias) may be treated with medicine or electric shocks.

11. EMERGENCY TREATMENTS
Angioplasty is a procedure to open narrowed or blocked blood vessels that supply blood to the heart.
Angioplasty is often the first choice of treatment. It should be done within 90 minutes after you get to the hospital, and no later than 12 hours after a heart attack.
A stent is a small, metal mesh tube that opens up (expands) inside a coronary artery. A stent is often placed after angioplasty. It helps prevent the artery from closing up again.

12. You may be given drugs to break up the clot
You may be given drugs to break up the clot. It is best if these drugs are given within 3 hours of when you first felt the chest pain. This is called thrombolytic therapy.
Some patients may also have heart bypass surgery to open narrowed or blocked blood vessels that supply blood to the heart. This procedure is also called open heart surgery.

13. AFTER YOUR HEART ATTACK
After several days, you will be discharged from the hospital.
You will likely need to take medicines, possibly for the rest of your life. Always talk to your health care provider before stopping or changing how you take any medicines.
While under the care of your health care team, you will learn:
How to take medicines to treat your heart problem and prevent more heart attacks
How to eat a heart-healthy diet
How to be active and exercise safely
What to do when you have chest pain 
How to stop smoking

14. After a heart attack, you may feel sad
After a heart attack, you may feel sad. You may feel anxious and worry about being careful about everything you do. All of these feelings are normal. They go away for most people after 2 or 3 weeks. You may also feel tired when you leave the hospital to go home.
Most people who have had a heart attack take part in a cardiac rehab program.