Angina - Dx, Ix, Mx Flashcards
Dx of stable angina
- based on ?
- pain of myocardium, from a ? ache to a ? pain that provokes ? and fear
- provoked by ?, esp after ?, in the ?, and if pt angry/excited
- fades quickly with ?, for some it occurs at ? levels of exertion
- may be ass w ?
history mild severe sweating exercise meals cold rest predictable sob
O/e - usually ? abnormalities - sometimes a ? HS, and ? should always be done
2 variants of stable angina.
? angina - provoked by ? ?, due to incr ? return to heart, ass w ???
variant/? angina - at ? due to cor aa ? - there is ? elevation during episode, so consider if this is found without a rise in ?
no, 4th, BP
decubitus, lying down, venous, LVF
prinzmetal’s, rest, spasm, ST, trop
Ix
exclude other causes - four bloods?
resting ??? - usually normal, poss signs of prev ? - consider ?? if LVH/LBBB
then use assessment and ECG findings to estimate likelihood of ??? using the NICE tool
glucose, lipids, tfts, fbc ecg infarction aortic stenosis CAD
Ix
if >?%, treat as ? angina - this includes all men over ? with angina pain
if 61-?% - coronary ? is indicated
if ?-60% - ? imaging indicated - SPECT perfusion scan, ? echo, ? MRI
if 10-?% - CT ? scoring is used
if <10% - Ix for ? cause
90% - stable, 70 90, angio 31, functional, exercise, stress 30, calcium another
stress 12 lead ecg
if ? ecg normal, use ? protocol on treadmill -> ST ? >1mm indicates ?
if positive within ? mins then ? indicated
resting bruce depression ischaemia 6 angio
Mx
inform pts that disease holds ? prog
treat underlying problems and ?
manage risk factors with ? advice
sx trt
- ? ? + BB/??? as first line
- combination therapy (NEVER give ??CCB with a BB - can cause ? - use BB and other CCBs like ?)
- or ? for refractory disease
good coomorbidities lifestyle GTN spray CCB RL asystole amlodipine nicorandil
Secondary prevention - ?, low dose ?, ACEi if comorbid ?
refer to cardio if any doubt over Dx, ? features, or ? sx
statin, aspirin, DM
atypical
refractory
