Stable Angina Flashcards
What is ischaemia?
Mismatch between supply of oxygen and metabolites and demand for them
Causes of ischaemia?
obstructive coronary atheroma
coronary artery spasm
coronary inflammation
Symptoms?
retrosternal pain
tight band/pressure/heaviness
radiation to neck or jaw or arm
History?
breathless on exertion
excessive fatigue
Risk factors for coronary artery disease?
age, gender, creed, family, and genetics
smoking, lifestyle, diabetes mellitus, hypertension, hyperlipidaemia
Examination signs?
tar stains on finger obesity xanthalasma and corneal arcus AAA arterial bruits retinopathy pallor of anaemia tachycardia
Investigations?
bloods - full blood count
CXR - helps show/rule out other causes
ECG - normal in over 50%, may be pathological q waves or ST depression
Exercise tolerance test - doesn’t exclude coronary atheroma if negative
Myocardial perfusion imaging - expensive
CT coronary angiography
Invasive angiography
Cardiac catheterisation
General measures of treatment?
address risk factors
blood pressure, cholesterol, lifestyle
Drugs to reduce progression?
statins, ACE inhibitor, aspirin
Drugs to relieve symptoms?
beta blockers, CCBs, IK channel blockers, nitrates
Other treatments?
Revascularisation with percutaneous coronary intervention e.g. stenting or coronary artery bypass grafting
What are the contraindications of beta blockers?
Asthma
Peripheral vascular disease
Raynaud’s syndrome
Heart failure
What are the adverse effects of CCBs?
Ankle oedema
Headache
Flushing
Palpitation
