Angina Flashcards
describe unstable angina
angina of increasing frequency or severity.
occurs on minimal exertion or at rest
describe decubitus angina
angina precipitated by lying flat
give the three classical features of angina
- constricting/heavy discomfort to the chest/jaw/neck/shoulders/arms
- symptoms brought on by exertion
- symptoms relieved by 5mins rest/GTN
what is angina
symptomatic, reversible ischaemia
what are three other potential precipitants for angina
emotion
cold
heavy meals
give some more unusual causes of angina
anaemia coronary artery spasm tachyarrhythmias HCM Small vessel disease/arteritis AS
describe stable angina
induced by effort, relieved by rest
when should patients be advised to seek help
if pain is still present >5mins after second dose
how should you manage angina
GTN spray or sublingual tabs
Anti-anginal meds:
- BB +/- CCB
Other options:
- long acting nitrates
- ivabradine
- nicorandil
Address exacerbating factors:
- stop smoking, exercise, dietary advice
- address hyperlipidaemia
- aspirin
Revascularistation:
- PCI
- CABG
what does ivabradine do
decreases HR with minimal effect on BP
describe variant angina
caused by coronary artery spasm
what investigations should you do in patients with stable angina
exercise ECG
angiography
functional imaging
