What is Angina & sycope in same patient is seen in- and explain in detail?
Exeional dyspnea, angina pectoris, and syncope are the three cardinal symptoms. Often, there is a history of insidious progression of fatigue and dyspnea associated with gradual cuailment of activities. Dyspnea results primarily from elevation of the pulmonary capillary pressure caused by elevations of LV diastolic pressures secondary to reduced left ventricular compliance and impaired relaxation. Angina pectoris usually develops somewhat later and reflects an imbalance between the augmented myocardial oxygen requirements and reduced oxygen availability. Exeional syncope may result from a decline in aerial pressure caused by vasodilation in the exercising muscles and inadequate vasoconstriction in nonexercising muscles in the face of a fixed CO, or from a sudden fall in CO produced by an arrhythmia. ( Harrison&;s principle of internal medicine,18th edition,pg no. 1939)