Angina Flashcards
What happens in the process of angina
Coronary arteries narrow to reduce blood flow to heart, so times during stress there is insufficient blood supply
Symptoms of angina
Chest pain with or without radiation to jaw or arms
What defines stable angina
When symptoms are relieved by rest or GTN spray
What defines unstable angina
When symptoms come on randomly whilst at rest - considered ACS
Gold standard diagnostic investigation for angina
CT coronary angiography
Management of angina principles
Refer to cardiology
Advise them about diagnosis, management and safety net
Medical treatment
Procedural or surgical interventions
Three aims of medical management
Immediate symptomatic relief, long term symptomatic relief, secondary prevention of CVD
What is used for immediate symptom relief
GTN spray, can repeat 5 mins after but only twice
What is used for long term symptomatic relief first line
Beta blocker (bisoprolol 5mg) or calcium channel blocker (amlodipine 5mg)
What is used for long term symptomatic relief second line
Long acting nitrates, ivabradine, nicorandil, ranolazine
what is used for secondary prevention
Aspirin, atorvastatin, ACEI and beta blocker
Procedural or surgical interventions for angina
Percutaneous Coronary Intervention (PCI) with coronary angioplasty or Coronary artery bypass graft (CABG)
Where would you find scars from a previous CABG
MIdline sternotomy scar
Where would you find scars from a previous PCI
Brachial and femoral arteries
