1.  Angina Kyle Christakos, David Cohee, Wade Dowling, Paul James, Levi Street, Stanton Urling

2. Pathophysiology  Angina is a chest pain or discomfort that occurs if an area of the heart dos not receive enough oxygen-rich blood.  Angina is a symptom of an underlying disease –most commonly CHD and it’s subsequent plaque buildup.

3. Risk Factors  High blood pressure  High cholesterol levels  Smoking  Diabetes  Overweight/obesity  Metabolic syndrome  Sedentary lifestyle  Age  Family history

4. Signs and Symptoms  Pain and discomfort are the main symptoms.  Nausea  Fatigue  Shortness of breath  Weakness  Sweating  Lightheadedness  For S&S of the specific types of angina see: http://www.nhlbi.nih.gov/health/health- topics/topics/angina/signs

5. Tests and Measures  Questioning ie how often does the pain occur? What relieves and worsens the pain? etc.  Stress testing  Chest X Ray  Blood Tests  Electrocardiogram  Echocardiogram

6. How to Proceed  Stop exercise and refer to physician if signs/symptoms of angina persist  Treat conservatively if referred from physician with documented knowledge of angina.

7. References  Nhlbi.nih.gov. Who Is at Risk for Angina? - NHLBI, NIH. 2015. Available at: http://www.nhlbi.nih.gov/health/health- topics/topics/angina/atrisk. Accessed July 7, 2015.  Mather, JJ. Differential diagnosis of a patient referred to physical therapy with neck pain: a case study of a patient with an atypical presentation of angina. J Man Manip Ther. 2012 Nov; 20(4): 214–218.