Angina

Question 1

Definition (& types)

Answer 1

A descriptive term for chest pain arising from the heart as a result of myocardial ischaemia (reduced blood flow to the heart)

2 types (stable and unstable)

Stable is more common and have triggers such as exercise and stress (normally lasts up to 10 minutes)

Unstable is more serious and unpredictable and attacks can continue despite resting

Question 2

Aetiology/ causes

Answer 2

Myocardial ischaemia (reduced blood flow to the heart) can be caused by coronary artery disease (atherosclerosis), blood clot, or coronary artery spasm

Can also be caused by aortic stenosis

Question 3

Risk factors

Answer 3

Hypertension
High cholesterol
Old age
Obesity
Diabetes (Type 1 and Type 2)
Reduced physical activity

Question 4

Epidemiology/ Population affected

Answer 4

Common for ages 60 and older

Family history may increase likelihood

Question 5

Clinical presentation

Answer 5

Central, crushing, or tight, retrosternal chest pain which frequently radiates to the arms and neck (can also cause parasthesia in one or both arms)

Coming on with exertion and relieved by rest within a few minutes

Exacerbated by cold weather, anger, and excitement

Shortness of breath, feeling sick, light-headedness, unexplained sweating

Question 6

Prognosis

Answer 6

Stable angina is a chronic medical condition with a low but appreciable incidence of acute coronary events and increased mortality

Question 7

DDX

Answer 7

Gastrointestinal: gastroesophageal reflux, hiatal hernia, peptic ulcer disease
Pulmonary: pneumothorax, pneumonia, pulmonary embolism
Musculoskeletal: costochondritis, rib injury, muscle spasm, chest wall injury
Psychiatric: panic attack, generalised anxiety
Cardiac non-ischaemic: pericarditis, myocarditis
Vascular: aortic dissection

Question 8

Additional aspects (Treatment and Pathophysiology)

Answer 8

Rest, Glycerol tri-nitrate