5.7 Medical management of stable angina and acute coronary syndromes Flashcards
define stable angina
chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest of nitroglycerin
what are the goals of angina treatment?
Prevent/minimise the ischaemia and improve survival
- Reduce plaque progression
- Stabalise plaque
- Prevent thrombosis if plaque rupture occurs
what happens in plaque instability?
rupture, thrombus formation, occlusion - Heart attack
what is the medical therapy for angina?
ACE inhibitor (anti hypertensive)
Statin
Beta blocker
what is the pharmacological treatment of an acute attack of angina?
Sublingual nitrate
What is the non-pharmacological treatment of angina?
Stop smoking dietary advice weight reduction if necessary exercise fish oils appropriate management of existing conditions Annual flu vaccine
what are the steps you would take in stable angina treatment?
Aspirin Maybe on antihypertensive (Beta blocker) Work up for cholesterol CT coronary angio stress test further intervention
what effect do nitrates have on stable angina?
cause systemic vasodilation which decreased myocardial oxygen demand
what effect do Ca channel blockers have on stable angina?
systemic and coronary vasodilation
define unstable angina
angina that worsens or changes (occurs at rest)
What is the initial treatment for unstable angina
Oxygen sublingual nitrate morphine beta blockers if no contraindication Aspirin
