stable angina Flashcards
What is stable angina
Discomfort in the chest associated with exertion - caused by myocardial ischaemia but without necrosis
What is the main cause of angina
Coronary atherome
What causes the stable angina symptoms
increased myocardial oxygen demand such as in exertion - the coronary artery is occluded and this leads to ischaemia and the angina symptoms
What are the causes of stable angina symptoms
Precipitated by excess myocardial oxygen demand e.g. exertion, cold weather, emotional stress, following heavy meal.
Describe the symptoms of stable angina
- Retrosternal pain which feels like a tight band is around them
- Radiates to the neck, jaw or down the arms
- Made worse with exertion
- Rapid improvement with GTN
- Breathlessness on exertion
Describe the canadian classification of angina severity
I - ordinary physical activity doesnt cause angina symptoms, only significant exertion causes the symptoms
II - Symptoms on walking 2 blocks or >1 flight of stairs
III - Symptoms on walking 1-2 blocks or 1 flight of stairs
IV - symptoms on any activity
How is stable angina diagnosed
ECG - signs of left ventricular hypertrophy - ST depression
What is used to influence stable angina disease progression
- statins if total cholesterol >3.5mmol/l
- ACE i if they have increased CV risk
- Aspirin
What treatment is given to stable angina for symptomatic relief
- GTN spray
- Beta blocker
- Calcium channel blockers - specificlally diltiazem and verapamil
What surgical intervention can be done for stable angina
- PCI - percutaneous coronary intervention - stent can be inserted into the arteries to mantain the lumen size and prevent the occlusion
- CABG - Coronary artery bypass graft - used in patients with >70% occlusion of coronary artery - long saphenous vein harvested and then used to bypass the coronary artery
What has to be taken after balooning done for stable angina
Aspirin and clopidogrel to prevent thrombus and atheroma formation
