GP Chronic Disease 2 - seb

Question 1

What is atherosclerosis? Risk factors? Complications? Usual locations? Symptoms?

Answer 1

Disease of elastic and large / medium sized arteries

Modifiable - smoking, HTN, hyperlipiaemia, DM, obesity
Non- age, male, FH

Comp- aneurysms, ischemia, infarct, thrombus, emboli

Abdominal aorta > coronary artery > popliteal artery > carotid

Angina, claudication

Question 2

ECG shows ST depression, what does this indicate? Pathology?

Answer 2

Ischemic heart disease

Atherosclerosis -> coronary artery stenosis -> ischemia

Question 3

Types of angina

Answer 3

Angina pectoris (stable)

Unstable (unstable at rest or on minimal exertion)

Decubitus (exacerbated by lying down)

Variant/Prinzmetal (coronary artery spasm during rest

Question 4

Seen on ECG of prinzmetal angina? Management?

Answer 4

transient ST elevation on ECG during pain,

CCB +/- Long-Acting Nitrates

Question 5

Stable angina Investigations? Management?

Answer 5

ECG - possible ST depression, old infarct
Exercise ECG 
Stress echo 
Coronary angioplasty
Cardiac CT 

Modify RF
Aspirin (75mg), B-blocker, nitrates, long acting CCB
PCI, CABG

Question 6

Which b-blocker in angina?

Answer 6

Atenolol - cardioselective

Question 7

Which nitrates in angina?

Answer 7

Symptomatic GTN

Prophylactic - isosorbide mononitrate

Question 8

Which CCB in angina?

Answer 8

Long acting - amlodipine / diltiazem

Question 9

Indications for use of statins? S.E? What do you need to monitor ?

Answer 9

Hx CVD 
Familial lipid disorder 
QRISK2 >10% (if under 84) 
T1DM >40yrs 
T2DM >10yrs 
Nephropathy 
CV RF 
CKD 

Fatigue, headache, nausea, indigestion, myopathy

Monitor creatine kinase