SIHD and Angina - Presentation and Investigation Flashcards
Define the pathophysiology of stable angina
It is defined as a supply and demand mismatch. The myocardium requires more oxygen and nutrients than is being supplied.
What is the most common cause of stable angina and why ?
Obstructive coronary heart Atheroma.
Blocks the coronary artery and when an individual exercises and demand increases the oxygen and nutrients cannot be supplied due to the atherosclerosis blockage
Name 5 risk factors for stable angina
1: Smoking
2: Hypertension
3: High cholesterol
4: Diabetes
5: Male
Name some of the clinical presentations of stable angina
1: Exertional chest pain – relieved with rest.
2: Stabbing type chest pain
3: Radiation of pain down left arm or up jaw
4: Signs of exacerbating of associated conditions.
5: May have hypertension or diabetes
6: Obesity
7: Hypercholesterolemia (Xanthalasma and corneal arcus)
Name the investigations that you would perform to help in the diagnosis of stable angina
1: Most important investigation is ECG
2: D-dimer (look for PE)
3: Bloods (blood glucose, lipid profile, U&E and thyroid tests)
4: CXR (to rule out other causes of chest pain
5: Exercise tolerance test.
6: Angiography
7: CT
What are the 3 main strategies adopted in the treatment of stable angina ?
1: General measure
2: Drug therapies
3: Revascularisation
What form of general measures are taken in the treatment of stable angina ?
Changing lifestyle factors such as hypertension, smoking, high cholesterol and diabetes
What drugs are used in the treatment of symptom relief in stable angina ?
Beta-blockers
Ca channel blockers
What drugs are used in the treatment of disease progression in stable angina ?
ACE Inhibitors
Statins
Aspirin
What 2 forms of revascularisation are offered to those with stable angina ?
1: PCI (angioplasty of coronary artery)
2: Bypass graft
