SIHD and Angina Flashcards
What is angina?
Chest discomfort
Myocardial ischaemia but no infarction
Caused by obstructive coronary atheroma
What is the other name for stable angina?
Angina pectoris
What are the features of angina chest pain?
Retrosternal
Tight band/pressure
Radiates to neck and arms
Exacerbated by exertion and emotional stress
Relieved by rest and GTN spray
What are other symptoms of angina?
Fatigue
Dizziness
SoB
Rapid breathing
Nausea
Heart palpitations
Sweating
Anxiety
What are the signs of angina?
Tar staining
Obesity
Xanthelasma
Corneal arcus
High BP
Absent/reduced peripheral pulses
Retinopathy
How is the severity of angina classified?
I- symptoms on exertion
II- symptoms on walking 2 blocks/1 flight of stairs
III- limits ordinary activity
IV- symptoms on any activity
What investigations are done for angina?
FBC
Lipid profile
Fasting glucose
electrolytes
LFTs
TFTs
CXR
ECG
What specialist investigations are done for angina?
Exercise tolerance test
Myocardial perfusion treatment
CT coronary angiography
Cardiac catheterisation
What does ischaemia show in myocardial perfusion treatment?
Tracer seen at rest
What does infarction show in myocardial perfusion treatment?
Tracer not seen at rest or in exercise
What does cardiac catheterisation involve?
Arterial cannula inserted into femoral or radial artery
Coronary catheter passed to aortic root
Contrast injected down coronary arteries
What are the 3 types of treatment for stable angina?
General measures
Medical treatment
Coronary revascularisation
What general measures are involved in treatment?
BP control
Cholesterol
Lifestyle
What is the medical treatment?
Statins- simvastatin
ACEIs- ramipril
Aspirin
Beta blockers- bisoprolol
CCBs- amlodipine
IK channel blockers- ivabradine
Short acting nitrates- GTN (vasodilator)
Long- acting nitrates- isosorbide mononitrate
K+ channel blocker- isosorbide mononitrate
What are the 2 types of coronary revascularisation?
Percutaneous coronary intervention (PCI)- coronary angioplasty (dilating blood vessel with a balloon and/or inserting a stent)
Coronary artery bypass surgery (CABG)- harvest long saphenous vein and graft it onto the aorta
