angina Flashcards
what are the 6 key questions you should ask in chest pain assessment?
how long have you had it? how long does it last? where is it? Localised/generalised/radiation? what's it like? what provokes it/relieves it?
how long should angina pain last?
a few minutes
where is angina pain felt?
localised in the chest wall
what does angina pain feel like?
feels like a constricting chest pain
what provokes and relieves angina pain?
provoked by exertion
relieved by rest
name causes of non-cardiac chest pains?
- Digestive – heartburn, swallowing disorders
- Neurogenic – cervical/thoracic spine, shingles
- Pulmonary – pleurisy, pulmonary fibrosis
- Bony pain – rib fracture, secondary deposits
why is early diagnosis important in non-cardiac chest pain?
because it means;
- fewer unnecessary investigations
- less distress and functional disability
- reduced costs to the hospital
- fewer iatrogenic complications
what are the 2 main causes of angina?
decreased myocardial O2 supply
increased myocardial O2 demand
what are causes of decreased myocardial O2 supply?
o Coronary artery disease; atherosclerosis, spasm, vasculitic disorders, post radiation therapy
o Severe anaemia
what are causes of increased myocardial O2 demand?
o Left ventricular hypertrophy; hypertension, aortic stenosis, aortic regurgitation, hypertrophic cardiomyopathy
o Right ventricular hypertrophy; pulmonary hypertension, pulmonary stenosis
o Rapid tachyarrythmias
name methods of diagnosing angina
Clinical assessment, Electrocardiography, LV wall motion analysis, Perfusion imaging
what is the diagnostic challenge with angina?
angina is a manifestation of coronary artery disease so the challenge is to determine whether or not the patient with chest pain has flow limiting coronary obstructions
name non-invasive testing options for angina
functional testing
anatomical testing
what is functional testing used for?
evidence of ischaemia
name methods of functional testing?
ETT, SPEC, stress echo, stress cMR
