stable angina

Question 1

what is angina?

Answer 1

Angina is Cardiac Chest Pain (Angina Pectoris) due to not enough blood flow to your heart muscle.

This is because there is a mismatch between the supply of Oxygen and Metabolites, and the Myocardial demand for them.

Question 2

what is stable angina?

Answer 2

Stable Angina is due to Myocardial Ischaemia (Blood flow to the heart is reduced, preventing it from receiving enough oxygen).

Question 3

what is stable angina represented by?

Answer 3

central chest tightness is brought on by:

exertion/effort (eg. exercise)

Anxiety/Emotional stress

After eating a large meal

Cold weather.

It may radiate to one or both arms, the neck, jaw or teeth.

(There is >70% stenosis due to plaque).

Question 4

what are 4 types of angina?

Answer 4

Stable Angina

Unstable Angina

Decubitus Angina

Variant Angina

Question 5

what are 4 diseases that causes angina?

Answer 5

Atheroma

Anaemia

Arteritis

Tachyarrhythmia’s

Question 6

what are 4 symptoms?

Answer 6

Chest Tightness - which can radiate to the arm(s), neck, jaw, and teeth

Exertional Breathlessness

Exertional Fatigue

Exertional (near) Syncope

Question 7

what are some signs?

HAAATT CODX

Answer 7

Hypertension

Anaemia

Abdominal Aortic Aneurysm

Absent or reduced femoral pulses

Tachypnoea

Tar-stained fingers

Corneal Arcus

Obesity

Diabetic retinopathy

Xanthelasma

signs of heart failure

Question 8

what are 7 investigations to diagnose stable angina?

Answer 8

CXR

Coronary Angiography (uses a dye and x-rays to see how blood flows through the arteries in your heart)

Cardiac Catheterisation (catheter is inserted in an artery or vein in your groin, neck or arm to get to your heart)

CTECG (usually normal, but maybe ST depression, flat or inverted T waves, signs of MI)

Exercise Tolerance Test (ETT)

FBC

Myocardial Perfusion Imaging

Question 9

what are 5 treatments?

Answer 9

1. B-Blockers (Relief)
2. Calcium Channel Blockers (Relief)
3. Nitrates/Ivabradine (Nitrates is for symptom relief, and Ivabradine reduces heart rate)
4. ACE Inhibitors (Prevention)
5. Aspirin/Statins (Prevention) (Aspirin, 75-150mg/24h, reduced mortality by 34%)

Question 10

what are the 4 angina classifications?

Answer 10

Stage I - No limitation on ordinary physical activity

Stage II - Normal at rest. Ordinary physical activity causes breathlessness

Stage III - Normal at rest. Less-than-ordinary activity causes breathlessness

Stage IV - Symptoms at rest