Stable angina Flashcards
stable angina
crushing chest pain occurring on exertion relieved by rest or GTN spray
aetiology of stable angina
atherosclerosis
pathophysiology
- Narrowing of the coronary arteries reduces blood flow to the myocardium (heart muscle)
- During times of high demand such as exercise there is insufficient supply of blood to meet demand, which causes the symptoms of angina
clinical presentation of stable angina
- central or left sided chest discomfort
- described as tight or crushing sensation
- symptoms not present at rest
ECG
- May be normal
- May show pathological Q waves, LBBB or ST-segment depression and T wave abnormalities
CT coronary angiography
- Diagnostic
- Radiation
- Non-invasive
other imaging
exercise tolerance
myocardial perfusion scan
CT angiography
catheter angiography
exercise tolerance test
first investigations offered to patients with suspected angina
myocardial perfusion scan
radiation
patients put under stress due to prior test
CT angiography
less invasive than catheter but provides less reliable information
catheter angiography
invasive but provides best accuracy
lifestyle interventions
- Diet and exercise advice
- Smoking cessation
- ↓ alcohol intake
- BMI of 25 or less
immediate symptomatic relief
GTN spray
causes vasodilation to allow more O2 through vessel
long term symptomatic relief
rate limiting drugs
vasodilators
rate limiting drugs
beta blockers
CCBs
ivabradine
