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Yr 3 Cardiovascular > Angina > Flashcards

Angina Flashcards

1
Q

What is unstable angina?

A

Unstable angina is a type of acute coronary syndrome that is defined as one or more of the following in patients whose cardiac biomarker levels do not meet criteria for acute myocardial infarction (MI):

Rest angina that is prolonged (usually > 20 minutes)

Unstable angina is clinically unstable and often a prelude to myocardial infarction or arrhythmias or, less commonly, to sudden death.

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2
Q

Define angina:

A

acute chest pain due to reversible coronary ischaemia

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3
Q

give 6 modifiable risk factors for angina?

A
  1. Smoking
  2. Hypertension
  3. Uncontrolled diabetes
  4. Hyperlipidaemia
  5. Sedentary lifestyle
  6. Obesity
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4
Q

Give the 3 key clinical features of stable angina:

A

1) constricting/ heavy discomfort to the chest, jaw, neck, shoulders or arms
2) brought on by exertion
3) symptoms are relieved by 5 min rest or GTN

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5
Q

What does GTN stand for?

A

glyceryl trinitrate

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6
Q

What is typical angina?

A

angina with all 3 clinical features

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7
Q

What is atypical angina?

A

Angina with just 2 key features

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8
Q

What is stable angina?

A

Occurs with exercise or emotional stress and is relieved by rest or nitroglycerin

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9
Q

What is unstable angina?

A

occurs at rest with acute onset (a type of acute coronary syndrome)

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10
Q

What is Prinzmetal’s angina?

A

angina at rest due to coronary artery spasm

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11
Q

How does Prinzmetal’s angina present on ECG?

A

ST elevation

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12
Q

What is microvascular angina?

A

exercise-induced angina with unobstructed coronary vessels

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13
Q

What is refractory angina?

A

a serious coronary disease where revascularisation is not possible and angina pain and symptoms cannot be controlled

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14
Q

What is refractory angina?

A

a serious coronary disease where revascularisation is not possible and angina pain and symptoms cannot be controlled by medical therapy (Chronic, doesn’t respond to treatment)

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15
Q

Give 5 lab tests that may be ordered to investigate suspected angina:

A

1) FBC
2) TFT
3) HbA1C
4) eGFR
5) troponin

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16
Q

Why would we want to order a TFT and HbA1C to investigate a suspected angina?

A

hyperthyroidism and hyperglycaemia can cause cardiomegaly and thus an oxygen demand supply balance

17
Q

Why would we want to order troponin to investigate a suspected angina?

A

to rule out an MI

18
Q

Name 4 scans/ non-lab tests that may be used to investigate a suspected angina:

A

1) ECG
2) echocardiogram (to assess left ventricular ejection fraction and regional wall abnormalities
3) CXR (to check for HF)
4) CT coronary angiography

19
Q

Give the 3 stages of angina management:

A

1) lifestyle modification and short acting nitrates
2) beta blockers and/ or calcium channel blockers
3) revascularisation

20
Q

What suffix do beta blockers have?

A

-olol

21
Q

Name 3 common calcium channel blockers:

A
  1. diltiazem
  2. Amlodipine
  3. verapamil
22
Q

Give two examples of long acting nitrates:

A
  1. ivabradine
  2. nicrorandil
23
Q

Give the two main types of coronary revascularisation surgeries:

A

1) percutaneous coronary intervention (dilating vessels with balloons or stents)
2) coronary artery bypass crafting (arteries and veins are attached to native coronary arteries distal to areas of stenosis)

24
Q

What receptors do beta blockers act on?

A

beta adrenoreceptors

25
Q

How do beta blockers treat angina?

A

they inhibit beta adrenoreceptors which decreases heart rate and blood pressure, reducing myocardial oxygen consumption

26
Q

How does ivabradine reduce heart rate?

A

it inhibits the pacemaker

27
Q

How does nicorandil treat angiNA?

A

it activates ADP sensitive K+ channels and has nitrate properties, causing vasodilation

28
Q

How does ranolazine treat angina?

A

it inhibits Na+ channels in cardiac cells, reducing heart rate and metabolic demand

29
Q

Give 4 event reducing drugs for angina:

A

1) aspirin
2) clopidogrel
3) ACEi
4) statins

30
Q

How does aspirin work as an antiplatelet?

A

it inhibits COX-1 and thromboxane

31
Q

How does clopidogrel work as an antiplatelet?

A

it antagonises P2Y12

32
Q

What is the name of the syndrome characterised by unpredictable angina with normal coronary vessels with ST segment depression on ECG?

A

Cardiac syndrome X

33
Q

How does cardiac syndrome X present on an ECG?

A

ST segment depression

Yr 3 Cardiovascular (28 decks)

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