Stable Angina Flashcards
What is stable angina also known as?
Angina pectoris - chest pain on EXERTION
It is characterized by chest pain on exertion due to myocardial ischaemia.
What age group is most commonly affected by stable angina?
Age 60-70
It is more prevalent in older adults + MEN
What is the primary cause of stable angina?
Atherosclerosis –> coronary artery disease (CAD)
It involves the accumulation of lipids forming plaques that narrow the coronary arteries.
What are some other causes of stable angina?
- Coronary artery vasospasm
- Microvascular dysfunction
- Other cardiac conditions (e.g., aortic stenosis, anaemia)
These conditions can increase oxygen demand or decrease supply.
What triggers chest pain in stable angina?
- Chest pain occurs as when there is an increase in myocardial oxygen demand e.g. stress/exercise due to transient ischaemia causing chest pain due to reduced bloos supply.
What are the key symptoms of stable angina?
- Exertional chest pain (squeezing/burning sensation)
- Dyspnoea
- Fatigue
- Nausea
- Sweating or light-headedness
Symptoms may vary, especially in women, the elderly, and patients with diabetes.
What are the three criteria for typical angina according to NICE classification?
- Constricting discomfort in chest/neck/shoulder/jaw/arms
- Precipitated by physical exertion
- Relieved by GTN in 5 minutes
Meeting all three criteria indicates typical angina, two criteria indicates atypical angina and only 1 criteria is not angina
What is the first-line investigation for stable angina?
ECG and blood tests
ECG may show signs or be non-specific; blood tests include troponins, FBC, U&Es, LFTs, HbA1c.
What is the second-line investigation for stable angina?
CT coronary angiography
This imaging technique helps visualize coronary artery health.
What are some differential diagnoses for stable angina?
- GORD
- Panic Disorder
- Pericarditis
Each has distinct characteristics and triggers.
What is the 1st line management for stable angina?
- Lifestyle changes
- Aspirin
- Statin
- Sublingual glyceryl trinitarte (GTN) - angina attacks
- Beta-Blockers or Rate-limiting Calcium Channel Blocker (Diltiazem, Verapamil)
Lifestyle changes include diet and weight loss.
What is the 2nd line management for stable angina?
ADD
Beta blockers
OR
long-acting dihydropyridine Calcium-channel Blocker (Amlodipine, nifedipine)
RL CCB contraindicated with BB
What is a potential complication of stable angina?
- Myocardial Infarction (MI)
- Arrythmia
- HF (LV failure)
- Sudden cardiac death
Long periods of angina can lead to myocardial necrosis.
Fill in the blank: If beta-blockers are contraindicated, add _______.
isosorbide mononitrate
Asymmetric dosing can help manage symptoms.
What are the third-line interventions for stable angina?
- PCI (Percutaneous coronary intervention)
- CABG
These are surgical options for severe cases.
True or False: Examination findings in stable angina are often normal.
True
An S4 heart sound may be present.
