Coronary Artery Disease: Angina Pectoris

Question 1

What is Angina Pectoris?

Answer 1

This is chest pain or pressure, usually due to not enough blood flow to the heart muscle. It can be stable or unstable.

Question 2

How does stable ischemia present and what does this mean?

Answer 2

It presents as demand Ischaemia: ok at rest.

Most common type of Angina and can trakc the pattern of pain based on feelins and activity e.g. exercise or stress.

Question 3

What causes Stable Angina Pectoris?

Answer 3

Narrowing of the arteries by plaque formation in one or more locations. A stable atheroma is formed which is an uncomplicated fixed stenosis with or without symptoms.

Question 4

How is Stable Angina Pectoris treated?

Answer 4

It is relieved by Isosorbide Mononitratae

Question 5

What are the symptoms of Stable Angina Pectoris:

Answer 5

• Chest pain - ask for patterns i.e. constant or are there triggers?
• Dull ache
• REferred pain - shoulders, neck, jaw

Question 6

What is Unstable Angina Pectoris?

Answer 6

Acute coronary syndrome that causes unexpected chest pain and presents as Supply Ischaemia (even at rest). This is a medical emergancy

Question 7

What is Unstable Angina Pectoris caused by?

Answer 7

Caused by partial or total blockage of the artery by blood clots from ruptured atheromas.

Question 8

What is the other forms of Angina?

Answer 8

Prinzmetal’s Angina (variant)

Cardiac Syndrome X

Question 9

Describe Prinzmetal’s Angina (variant)

Answer 9

This will occur at rest often between midnight and early morning. It DOSN’T INVOLVE THE BLOOD FLOW TO THE HEART. It is caused by a spasm in the coronary artery and is very rare.
It is a chronic condition (not an emergancy) that can be treated with CCB or Nitrates.

Question 10

Describe Cardiac Syndrome X

Answer 10

This is angina without epicardial coronary disease.
It is likely to be a microvasxular diesease involving the microvessels of the heart.
More common in women due to association with sex hormones