Lecture 3: angina

Question 1

How do atherosclerotic plaques affect blood flow at rest and exercise?

Answer 1

Not much at rest, as there’s reserve capacity. But significantly during exercise as vessels cannot dilate

Question 2

If there’s pain in buttock or hip, where is the peripheral artery disease?

Answer 2

Aorta-iliac

Question 3

If there’s pain in the thigh, where is the peripheral artery disease?

Answer 3

Aorta-iliac or common femoral artery

Question 4

If there’s pain in the upper 2/3 of the calf, where is the peripheral artery disease?

Answer 4

Superficial femoral artery

Question 5

If there’s pain in the lower 1/3 of the calf, where is the peripheral artery disease?

Answer 5

Popliteal artery

Question 6

If there’s pain in the foot, where is the peripheral artery disease?

Answer 6

Tibial or peroneal artery

Question 7

How do you manage intermittent claudication?

Answer 7

Exercise programme

Angioplasty or bypass

Question 8

What technique is used to inject fluid to perform invasive CA?

Answer 8

Seldinger

Question 9

What is the downside of angiograms?

Answer 9

You cannot see the heart wall

• Pathology can occur in the wall
• Imaging doesn’t show the default arterial state: the artery may seem narrowed but this might be physiological

Question 10

What is class I angina?

Answer 10

Angina only present with strenuous exertion

Question 11

What is class II angina?

Answer 11

Angina with moderate exertion

Question 12

What is class III angina?

Answer 12

Angina with mild exertiion

Question 13

What is class IV angina?

Answer 13

Angina at rest

Question 14

What are the characteristics for typical angina?

Answer 14

1. Constricting discomfort in the front of the chest or neck, jaw, shoulder or arm
2. Precipitated by exercise or emotion
3. Relieved by nitrates or rest

Question 15

What is atypical angina characterised by?

Answer 15

Meets two of the angina characteristics

Pain of characteristic nature and location occurring at rest and for a prolonged period (>20min)