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Cardiology > Angina Pectoris > Flashcards

Angina Pectoris Flashcards

1
Q

Identify 5 risk factors for angina pectoris

A
  • Smoking
  • Hypertension
  • Diabetes
  • Obesity
  • Hypercholesterolaemia
  • Male gender
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2
Q

Identify the three features of angina pectoris

A
  • Pain is heavy and constricting
  • Pain is precipitated by physical exertion
  • Pain is relieved by rest or GTN within 5 minutes
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3
Q

What is atypical angina?

A
  • Presence of 2 out of 3 of the features of angina pectoris
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4
Q

Identify a finding on ECG in stable angina

A
  • ST depression
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5
Q

What are the criteria for performing 64-slice CT coronary angiography?

A
  • Clinical assessment indicates angina

- EEC demonstrates ST depression

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6
Q

What is the criteria for performing MPS with SPECT?

A
  • CT coronary angiography has shown coronary artery disease
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7
Q

What is the criteria for performing invasive coronary angiography?

A
  • Results of MPS with SPECT are inconclusive.
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8
Q

Identify 5 differential diagnoses of angina pectoris

A
  • Aortic dissection
  • Pericarditis
  • Pulmonary embolism
  • Pneumothorax
  • Gastroesophageal reflux disease
  • Biliary colic
  • Acute cholecystitis
  • Costochondritis
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9
Q

When should GTN spray be prescribed in angina pectoris?

A
  • Symptom relief whilst awaiting specialist referral
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10
Q

Identify two possible first-line treatments for angina pectoris

A
  • Beta blocker (atenolol)

- Rate limiting calcium channel blocker (verapamil or diltiazem)

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11
Q

Identify four alternative first-line treatments if both beta-blockers and calcium channel blockers are contraindicated

A
  • Isosorbide mononitrate
  • Ivabradine
  • Nicorandil
  • Ranolazine
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12
Q

What is the second line treatment of angina pectoris?

A
  • Beta blocker or calcium channel blocker.

- Plus 1 alternative

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13
Q

What is the third line treatment of angina pectoris?

A
  • Beta blocker or calcium channel blocker.

- Plus 2 alternatives

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14
Q

Identify 4 drugs for the secondary prevention of cardiovascular disease

A
  • Aspirin
  • Rivaroxaban
  • Ramipril
  • Atorvastatin
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15
Q

Identify 2 conditions for considering revascularisation (CABG or PCI)

A
  • Symptoms are not controlled with medication

- Angiography demonstrated left main stem disease or three-vessel disease

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16
Q

Identify an advantage of CABG over PCI

A
  • Survival advantage in patients with diabetes, 65+ and have three-vessel disease
17
Q

When is a diagnosis of microvascular angina considered?

A
  • Continuing symptoms despite drug treatment and revascularisation
  • Normal coronary arteries
18
Q

Identify three adverse effects of rate limiting calcium channel blockers

A
  • Constipation
  • Bradycardia
  • Heart block
  • Hot flushes
  • Headache
  • Ankle oedema
19
Q

Identify two contra-indications of rate limiting calcium channel blockers

A
  • Heart block
  • Unstable angina
  • Severe aortic stenosis
20
Q

Identify three adverse effects of cardioselective beta blockers

A
  • Fatigue
  • Cold extremities
  • Sleep disturbance
  • Nightmare
  • Impotence in males
  • Headache
  • GI disturbances
21
Q

Identify two contraindications of cardioselective beta blockers

A
  • Asthma

- Heart block

22
Q

Identify an important interaction of cardioselective beta blockers

A
  • Rate limiting calcium channel blocker

- Can cause heart failure and asystole

23
Q

Identify three side effects of nitrates

A
  • Flushing
  • Headaches
  • Hypotension
  • Tolerance
  • Methaemoglobinaemia in overdose
24
Q

Identify an importance interaction of nitrates

A
  • Phosphodiesterase 5 inhibitors
25
Q

Identify two contraindications of nitrates

A
  • Severe aortic stenosis

- Hypotension

26
Q

Identify three adverse effects of nicorandil

A
  • Flushing
  • Dizziness
  • Headache
  • Nausea
  • Vomiting
  • Hypotension
  • Ulceration of genitals, eyes and skin
27
Q

Identify three contraindications of nicorandil

A
  • Poor left ventricular function
  • Hypotension
  • Pulmonary oedema
28
Q

Why are rate limiting calcium channel blockers preferred over dihydropyridine calcium channel blockers for the treatment of angina?

A
  • Rate limiting calcium channel blockers lower heart rate and decrease myocardial contractility
  • Dihydropyridines can cause tachycardia which can worsen symptoms of angina
29
Q

Identify three lifestyle changes for patients with angina pectoris

A
  • Avoid provoking factors such as stress
  • Smoking cessation
  • Cardioprotective diet
  • Increase in physical activity
  • Limitation of alcohol consumption

Cardiology (16 decks)

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