stable angina

Question 1

what is angina

Answer 1

chest discomfort that lasts 10 minutes or less and subsides promptly with rest
occurs when myocardial oxygen demand exceeds supply, which is usually restricted by atherosclerotic obstruction

Question 2

treatment of episodes of angina

Answer 2

give all patients a written chest pain action plan
advise patients to stop activities as soon as angina pain is felt
to shorten an episode of angina, use
glyceryl trinitrate spray sublingually
OR
glyceryl trinitrate tablet
repeat every 5 minutes up to a total of 3 sprays/doses if pain persists

Question 3

when should patients call an ambulance

Answer 3

if the pain persists >10 minutes, they should take a third dose and call an ambulance

Question 4

instructions to give about using glyceryl trinitrate

Answer 4

before taking it, they should sit down to avoid orthostatic hypotension
consider giving a sign trial dise of glyceryl trinitrate undder supervision when the patient is asymptomatic so they will recognise it’s effect

Question 5

treatment to prevent angina

Answer 5

optimal treatment for underlying coronary artery dsease eg. aspirin, statin, hypertension medications
treat angina with single anti-anginal therapy initially
first line is beta blockers eg. atenolol, metoprolol
second line is calcium channel blockers eg. diltiazem or veramapril
you may add a long acting nitrate