Angina

Question 1

Define angina.

Answer 1

Disease of the coronary arteries to prevent blood reaching the heart. Heart fatigue - pain.

Question 2

Define atherosclerosis.

Answer 2

Build-up of cholesterol-rich plaques causing a stenosis of coronary arteries.

Question 3

How many types of angina are there?

Answer 3

5

Question 4

Angina of effort is to do with…

Answer 4

Increased oxygen demand with restricted blood flow.

Question 5

Give 3 symptoms of angina.

Answer 5

Tightness, squeezing, crushing of chest.

Question 6

Mixed (variable threshold) angina develops at…

Answer 6

Different levels of exercise.

Question 7

Vasospastic (Prinzmetal’s) is when there is a…

Answer 7

Spasm of the coronary artery. It occurs at night/rest.

Question 8

Microvascular (syndrome X) angina is constriction of the…

Answer 8

Microvasculature system.

Question 9

Unstable angina is characterized by a….

Answer 9

Non-occulsive thrombus. Leads to chest pain.

Question 10

Cardiac oxygen demand is a function of three things. Name them.

Answer 10

Wall tension. Contractility. Heart rate.

Question 11

Give 2 role of nitrates?

Answer 11

Reduce oxygen demand, reduce wall tension, reduce central venous pressure (preload), dilate coronary arteries.

Question 12

Define afterload.

Answer 12

Afterload is the force or load against which the heart has to contract to eject the blood.

Question 13

Define preload.

Answer 13

Preload is the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions under variable physiologic demand.

Question 14

What do beta-blockers do?

Answer 14

Inhibit sympathetic stimulation (inhibit adrenaline). Reduce cardiac output. Reduces release of renin from kidneys.

Question 15

Name a beta-blocker.

Answer 15

Propanolol. Bisoprolol. Atenolol. Metoprolol. Carvedilol. Labetalol.

Question 16

What do calcium ion channel blockers do?

Answer 16

Relax blood vessels. Leads to reduced total peripheral resistance (vasodilatation), reduced blood pressure, reduced afterload.

Question 17

What do negative inotropic agents do?

Answer 17

Negatively inotropic agents weaken the force of muscular contractions.

Question 18

Name 2 calcium ion channel blockers (CCBs).

Answer 18

Amlodipine. Verapamil. Diltiazem.

Question 19

What do K channel activators do?

Answer 19

Relax blood vessels. Leads to venous and arterial vasodilatation. This reduces preload, afterload, cardiac work and oxygen demand.

Question 20

Name a K channel activator.

Answer 20

Nicorandil.

Question 21

What does Ranolazine do?

Answer 21

It improves blood flow to help the heart work more efficiently. Reduces wall tension to reduce cardiac work (anti-angina medication).

Question 22

What does Ivabradine do?

Answer 22

Blocks the funny current to reduce heart rate and contractility. Allows more time for perfusion to heart.

Question 23

What does PCI stand for?

Answer 23

Percutaneous coronary intervention.

Question 24

What is a stent?

Answer 24

A tiny tube that your doctor can insert into a blocked passageway to keep it open.

Question 25

When is coronary bypass used?

Answer 25

For a severe disease.

Question 26

What is used to insert a stent?

Answer 26

A balloon which inflates.

Question 27

What does GTN stand for, and what is it used for?

Answer 27

Glyceryl trinitrate. It’s a NO donor, to treat angina.

Question 28

What is an Inotrope?

Answer 28

inotrope is an agent that alters the force or energy of muscular contractions. Negatively inotropic agents weaken the force of muscular contractions. Positively inotropic agents increase the strength of muscular contraction.

Question 29

What does DHP stand for?

Answer 29

Dihydropyridine.