Stable Angina

Question 1

What are the risk factors of angina?

Answer 1

CARDIAC: Aortic stenosis, HOC
METABOLIC: diabetes, hyperlipidaemia
LIFESTYLE: smoking, obesity, lack of exercise
OTHER: FHx

Question 2

What are the 3 NICE criteria to define angina pain?

Answer 2

1. Constricting discomfort in chest, neck shoulder, arm or jaw
2. Precipitated by exercise
3. Relieved by rest OR GTN spray in 5 min

>2 = TYPICAL
>1 = ATYPICAL
1/0 = non-angina cardiac pain

Question 3

What medication is used to treat stable angina attacks?

Answer 3

1. Sublingual GTN spray
2. Beta blocker (e.g. ATENOLOL) or calcium channel blocker (e.g. AMLODIPINE)
3. If can’t tolerate (2) -
   - long acting nitrate (e.g. Isosorbide mononitrate),
   - Ivabradine
   - Nicorandil
   - Ranolazine

Question 4

What medication is used for secondary prevention of cardiovascular disease?

Answer 4

1. Antiplatelet (e.g. 75mg ASPIRIN)
2. ACEi IF stable angina + HTN/diabetes/previous MI/HF/CKD
3. Statin
4. anti-HTN

Question 5

When should people by admitted to hospital?

Answer 5

1. Pain at rest (may occur in night)
2. Pain on minimal exertion
3. Angina that seems to be rapidly progressing despite medication