Angina

Question 1

what is Decubitus angina?

Answer 1

induced by lying down

Question 2

what is Prinzmetal’s / variant angina ?

Answer 2

occurs during rest

Question 3

what causes variant angina?

Answer 3

Due to coronary spasm

Question 4

what is the treatment for variant angina?

Answer 4

CCB + long-acting nitrate

Question 5

what is Syndrome X?

Answer 5

angina pain + ST elevation on exercise test but no evidence of coronary atherosclerosis.
􏰁
Probably represents small vessel disease

Question 6

if GTN, B blockers and CCB don’t control angina symptoms what medication can be used?

Answer 6

ISMN 20-40mg BD (8h washout @ PM) or slow-release nitrate (Imdur 60mg OD)

􏰀 Ivabradine (esp. if can’t take β-B)

􏰁 Nicorandil 10-30mg BD

􏰁 Ranolazine

Question 7

what are the indications for CAGB?

Answer 7

L main stem disease
􏰁 Triple vessel disease
􏰁 Refractory angina
􏰁 Unsuccessful angioplasty

Question 8

what are the complications of CAGB?

Answer 8

MI
􏰁 Stroke
􏰁 Pericardial tamponade or haemothorax 􏰁 Postperfusion syn.
􏰁 Post-op AF
􏰁 Nonunion of sternum
􏰁 Graft stenosis