Chronic Stable Angina (CSA) Flashcards
Describe chest pain in angina
Squeezing, grip-like, heavy or suffocating and typically doesn’t vary with position or respiration
What’s stable angina also known as?
Stable ischemic heart dx (SIHD)
What’s stable angina or SIHD associated with?
Predictable chest pain often brought on by exertion or emotional stress and relieved within minutes by rest (or nitroglycerin)
What causes stable angina?
Plaque build up on the inner walls of coronary arteries (atherosclerosis) causing narrowing in the arteries and reduced blood flow to heart
What’s Prinzmetal’s (variant or vasospastic angina) angina?
Angina that’s present in pts with NORMAL coronary arteries, where angina sx are as a result of vasospasm in the arteries
List types of angina
Stable angina
Prinzmetal’s angina
Silent ischemia
Unstable angina
What’s stable angina?
Decreased myocardial O2 supply to due to reduced blood flow from narrowed arteries by atherosclerotic plaque
Sx have been occurring for weeks but without worsening
What’s Prinzmetal’s angina?
Decreased myocardial O2 supply due to vasospasm of the artery
What’s silent ischemia?
Transient myocardial ischemia without sx of angina
What’s unstable angina?
Severe, crushing chest pain unrelieved by rest; acute medical care is needed
What’s the non-pharmacologic tx of CSA?
Heart healthy lifestyle saturated fats < 7% of total calories and Trans fat < 1% of total calories Fresh fruits and vegetables Low fat dairy pdts
Stop smoking
Maintain BMI of 18.5-24.9 kg/m2
Waist circumference
Females < 35 inches
Males < 40 inches
Encourage physical exercise
30-60 minutes of moderate-intensity aerobic activity, at least 5 days a wk, preferably 7 days a wk
What’s a Heart healthy lifestyle in CSA?
saturated fats < 7% of total calories
Trans fat < 1% of total calories
Fresh fruits and vegetables
Low fat dairy pdts
How much saturated fat should be consumed in heart healthy lifestyle in CSA?
< 7% of total calories
How much trans fat should be consumed in heart healthy lifestyle in CSA?
< 1% of total calories
What’s the recommended BMI in CSA?
18.5 - 24.9 kg/m2
What’s the recommended waist circumference in CSA?
Males < 40 inches
Females < 35 inches
Whats the tx goals of CSA?
Reduce the risk of an acute coronary syndrome (unstable angina/ myocardial infarction) and provide symptomatic relief from angina pain
What’s combo is most often used to meet the tx goals of CSA?
Antiplatelet (usually Aspirin; Plavix is allergy or CI to aspirin) + Antianginal
What’s the first line therapy for tx of CSA?
Beta blockers
CCB or long-acting nitrates are used when bb is CI or when additional relief is needed
What’s recommended for immediate relief of angina?
Sulpblingual nitroglycerin or nitroglycerin spray
What med should ALL pts with CSA be on regardless?
Moderate or high dose statin (regardless of LDL values)
What annual vaccine is recommended in CSA?
Annual flu shot
What’s the acronym that summarizes the non-pharmacologic and pharmacologic therapies in chronic therapy?
A - Antiplatelet and Antianginal drugs
B - Blood pressure and beta-blockers
C - Cholesterol (statins) and cigarettes
D - Diet and diabetes
E - Exercise and education
List Antiplatelet agents
Aspirin (Bayer, Ascriptin, Bufferin)
Clopidogrel (Plavix)