angina Flashcards
when does it occur
when there is a mismatch between blood supply and metabolic demand
ECG changes
- ST-T changes
symptoms
- chest pain (heavy, tight)
- central pain
- pain can radiate to jaw/arms
what does adenosine do
stimulate nerve endings and produce pain
who gets it
risk
- increase with age
- hypertension
- hyperlipidaemia
- diabetes
- obesity
- smoking
diagnosis
largely clinical
when does pain occur
usually during exercise
when does unstable angina pain occur
at rest
what can be found on examination
- S4
- anaemia
- thyrotoxicosis
- hyperlipidaemia
investigations
- FBC
- troponin (unstable)
- ECG
- echo
- CXR
what is first line treatment
to change their lifestyle
management algorithm
- lifestyle + nitrates
- beta blocker or calcium
- ivabradine/nicorandil/ranolazine
- revascularisation
- PCI or CABG
side effect of isosorbide mononitrate
- headache
- flushing
what does bisoprolol do
- inhibit beta-adrenoreceptor
- reduces heart rate and BP
- reduces myocardial oxygen consumption
cautions for use of beta blockers
- COPD
- acute heart failure
side effects of beta blockers
- fatigue
- peripheral vasoconstriction
- sexual dysfunction
- bronchospasm
side effect of verapamil
constipation
side effect of amlodipine
- ankle oedema
- reflex tachycardia
how does ivabradine work
- inhibits pacemaker current (funny current)
side effects of ivabradine
- bradycardia
- sick sinus syndrome
how does ranolazine work
inhibits late sodium channels into cardiac cells
how is ranolazine metabolised
by cytochrome P450
ranolazine SE
- constipation
- dizziness
- lengthened QT
mechanism of aspirin
reversible inhibition of COX1 and thromboxane
