Angina Flashcards
1) What is angina?
2) When is angina considered stable?
3) When is angina considered unstable?
1) The narrowing of the coronary arteries reduces blood supply to the heart during times of high demand i.e. physical exertion. This results in constricting chest pain that may radiate to the jaw
2) When the angina is relieved by rest or GTN spray
3) When angina occurs randomly i.e. during rest
1) What is the gold standard investigation for angina?
2) Name a 2nd line investigation
1) CT coronary angiography
2) Myocardial perfusion imaging, stress echo, MRI for regional wall motion abnormalities
1) How are episodes of angina prevented and treated?
2) After the first dose, how long should be waited before taking the second if symptoms persist?
3) What should be done if the symptoms don’t go 5 mins after second dose?
1) Short acting nitrate i.e. GTN spray
2) 5 mins
3) Call ambulance
1) Which 2 drugs are first line for angina management?
2) If either of these drugs don’t work, what’s given next?
3) Name an option if both of these drugs don’t work as a monotherapy, and they’re not tolerated together
1) CCB (verapamil or diltiazem) or beta blocker
2) Used in combination (CCB switched to dihydropyridine CCB i.e. amlodipine, nifedipine)
3) Ivabradine, ranolazine, nicorandil, long acting nitrate
How does a percutaneous coronary intervention with angioplasty work as a procedural intervention for angina?
A catheter is inserted into the patients brachial or femoral artery, and its fed up to the coronary arteries with x-ray guidance and contrast is injected so that the coronary arteries and any areas of stenosis are highlighted on x ray images. These areas can be treated with balloon dilation followed by stent insertion
How does a coronary artery bypass graft work as a procedural intervention for angina, and how does it differ from PCI in outcomes?
A graft vein is taken from the patient’s leg and sewn on the affected coronary artery to bypass the stenosis. Slower recovery and more complications than PCI
