Angina

Question 1

What is stable angina?

Answer 1

Constricting chest pain, only during exertion

Question 2

What is unstable angina?

Answer 2

Constricting chest pain, that can occur both during exertion, and at rest

Question 3

What initial investigations should be performed in a patient with suspected angina?

Answer 3

ECG
FBC - anaemia
U&Es
LFTs
TFTs
Lipid profile
HbA1c

Question 4

What further investigations can be performed to confirm angina?

Answer 4

Cardiac stress testing
CT coronary angiography
Invasive coronary angiography

Question 5

What immediate relief can be given to treat angina?

Answer 5

GTN spray

Question 6

How is GTN spray taken?

Answer 6

Take GTN when symptoms start
Can take second and third doses at intervals of 5 minutes
Call an ambulance if symptoms do not resolve after third dose

Question 7

What is the first line management for long term relief of angina?

Answer 7

Beta blockers (bisoprolol) or calcium channel blockers (diltiazem or verapamil)

Question 8

Which patients should diltiazem and verapamil be avoided in?

Answer 8

Heart failure with reduced ejection fraction

Question 9

What medicines are prescribed for secondary prevention of ACS?

Answer 9

4 As
- Aspirin
- Atorvastatin 80mg OD
- ACE inhibitor
- Already on a beta blocker