Ischaemic heart disease

Question 1

Describe stable angina?

Answer 1

atherosclerotic disease, limits heart’s ability to respond to increase in demand. symptoms on exertion and relieved by rest

Question 2

Describe unstable angina?

Answer 2

due to plaque rupture leading to formation of non-occlusive thromboembolism or vasospasm. Symptoms at rest

Question 3

How can you diagnose angina?

Answer 3

history
pain induced by exercise and relieved upon rest/ GTN
ECG - ST depression
angioplasty of coronary artery

Question 4

How can you manage angina?

Answer 4

smoking cessation 
weight loss 
diet 
exercise 
CABG 
PTCA & stenting

Question 5

How do nitrates work?

Answer 5

ventilation, decreases preload and reduction in cardiac work and coronary vasodilation

Question 6

How to beta blockers work?

Answer 6

-ve inotropic and chronotropic effects reducing cardiac work, slowing heart increases diastole time and therefore coronary blood flow

Question 7

What are the two classes of calcium channel blockers?

Answer 7

rate limiting

DHP

Question 8

What are the other functions of the rate limiting drug verapamil?

Answer 8

myocardial depressant and bradycardiac actions reducing cardiac work and an IV anti-arrhythmic activity

Question 9

What is Nicorandil?

Answer 9

potassium channel activator

Question 10

How does ivabradine work?

Answer 10

inhibits If channels reducing heart rate

Question 11

Can you administer a beta blocker with a rate limiting calcium channel blocker?

Answer 11

no use a DHP