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GP > Angina > Flashcards

Angina Flashcards

1
Q

What investigations should be done in Angina?

A 
ECG
BP
Cardiac Enzymes (Aand E if troponin is raised)
FBC
Fasting glucose and lipids
ESR
TFTs
at hospital:
CT angiogram to prove angina
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2
Q

What is first/second/third line medication in Angina?

A

BB (Bisoprolol) or CCB
(if one is ineffective try the other then try both)
Start at low doses and titrate up

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3
Q

What CCBs are used for what in Angina?

A

Verapimil is ionotrophic and slows heart down
Nifedipine is a vasoldilator and doesnt affect rate
Amlodipine is a vasodilator but long duration and given once daily

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4
Q

When can verapimil NOT be used?

A

With BBs

In heart failure

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5
Q

What is the 4th line treatment for angina?

A

Long acting nitrate while waiting for CABG or PCI

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6
Q

What is used in angina prevention?

A

ACEi
Statin
Antiplatelet = Aspirin 75mg

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7
Q

When should you admit patients with angina?

A
  • Current pain
  • Pain in last 12 hours with ECG changes
  • Pain 12-72 hours ago merits same day investigation in hospital
  • Pain >72 hours ago merits full assessment, ECG and troponin
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8
Q

What are the side effects of CCBs?

A

Headache
Flushing
Ankle Oedema
Constipation

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9
Q

What are the side effects of BBs?

A

Bronchospasm

Cold peripheries

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10
Q

What causes angina?

A

Coronary Artery Disease

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11
Q

Where does pain from angina radiate?

A

Jaw,
Neck
Arms

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12
Q

What is angina exascerbated by?

A

Excercise
Cold
Emotion
Heavy meals

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13
Q

What are risk factors for angina?

A

FH
Smoking
Vascular disease

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14
Q

What is angina pain associated wiht?

A

Sweating
Palpitations
Nausea
Breathlessness

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15
Q

What are the side effects of GTN spraY?

A

Flushing
Headache
Light headed

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16
Q

What is the lifestyle advice that must be given to someone with angina?

A 
Occupational hazards addressed
Smoking cessation
BP control
Diet
DM treat
Alcohol
Cardiac rehab 
Exercise
17
Q

What is the deal with driving and angina?

A

Dont need to tell the DVLA
You may continue to drive if you have angina (even if you need medication) unless it happens while resting, driving, or with emotion. You must stop driving until your symptoms are under control if it does.

18
Q

When are long acting nitrates contraindicated?

A

Aortic or mitral stenosis

19
Q

What is the issue with long acting nitrates?

A

Tolerance develops

20
Q

Give an example of a long acting nitrate

A

Isosorbide mononitrate

21
Q

What is unstable angina?

A

Pain at rest or on minimal excercise or at night

Can worsen fast

22
Q

What is needed in unstable angina?

A

Urgent Cardiology referral

23
Q

What is Prinzmetals angina?

A

Coronary artery spasm

24
Q

What is seen on ECG of Prinzmetals angina?

A

ST elevation

25
Q

How do you treat prinzmetals?

A

GTN, CCB and refer

GP (9 decks)

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