Angina

Question 1

What is stable angina?

What are the symptoms?

Answer 1

A narrowing of the coronary arteries reduces blood flow to the myocardium (heart muscle).

During times of high demand such as exercise there is insufficient supply of blood to meet demand.

This causes symptoms the symptoms of angina, typically constricting chest pain with or without radiation to jaw or arms.

Question 2

Stable Angina

Diagnosis

Answer 2

CT Coronary Angiography is the Gold Standard diagnostic investigation
(CI in AKI, contrast allergy etc. -then use myocardial perfusion SPECT scan)

Other baseline investigations needed:
ECG
FBC (check for anaemia)
U&Es (prior to ACEi and other meds)
LFTs (prior to statins)
Lipid profile
Thyroid function tests (check for hypo / hyper thyroid)
HbA1C and fasting glucose (for diabetes)

Question 3

Stable Angina

Managment

Answer 3

1. Beta Blocker
   (if contraindicated e.g. asthma: rate limiting Calcium Channel Blocker e.g. diltiazem)

+ GTN spray

2. • Calcium channel blocker
3. • Isoborbide Mononitrate

Secondary prevention:

• Atorvastatin 80mg
• ACE inhibitor
• A beta blocker (Which they’d already be on)
• Aspirin 75mg