Mixed angina pectoris

Mixed angina pectoris is characterized by angina occurring both when myocardial oxygen demand increases and when myocardial oxygen demand does not significantly increase but coronary blood supply decreases. It results from the combined effect of varying degrees of fixed and dynamic stenosis. Clinically, angina may be caused solely by increased myocardial oxygen consumption, solely by sudden reduction in myocardial blood supply, or by both factors simultaneously during an attack. The treatment principles should include the use of vasodilators to prevent vasospasm and vasoconstriction, as well as reducing myocardial oxygen consumption and improving exercise tolerance.