Angina and MI Flashcards
What are the differential diagnoses for chest pain?
Pulmonary
Cardiovascular
Musculoskeletal
What does typical angina present with?
All three of the features:
Precipitated by physical exertion
Constricting discomfort in the front of the chest, in the neck, shoulders, jaw, or arms
Relieved by rest or glyceryl trinitrate (GTN) within about 5 minutes
What does atypical angina present with?
2 of the 3 features for typical angina along with atypical symptoms like GI discomfort, breathlessness or nausea
What features are likely to lead to a diagnosis of stable angina?
Pain that is continuous or prolonged.
Pain that is unrelated to activity.
Pain that is brought on by breathing.
Pain that is associated with dizziness, palpitations, tingling, or difficulty swallowing
What are the different types of angina?
Stable
Unstable
Variant (prinzmetal)
How long does stable angina usually last?
Under 5 mins
How long does unstable angina usually last?
Longer than 5 mins, can be prolonged
What type of angina is relievable by medicine?
Stable angina
What type of angina can lead to MI?
Unstable
What is pain inn variant angina caused by?
A spasm in the coronary arteries caused by exposure to cold, stress, smoking etc
What are some risk factors for angina?
Alcohol use Tobacco use High BP Family history Gender
What are some tests performed for angina clinically?
ECG Coronary angiography Exercise tolerance test Lab tests Troponin
What are troponin levels after heart damage?
They are elevated within a few hours of heart damage and remain elevated for up to two weeks
If troponin is normal, what is likely the pain is caused by and what is it less likely the pain is caused by?
More likely that the pain is due to stable angina
Less likely that the symptoms and chest pain are due to heart muscle damage
What are first line treatments for stable angina?
Short acting nitrates with beta blocker or CCB
Other options if heart rate is low or if symptoms remain uncontrolled