Stable angina Flashcards
What is angina?
Discomfort in chest or surrounding areas associated with myocardial ischaemia but without myocardial necrosis
What is the pathophysiology od angina?
Mismatch between supply and demand of O2 nd metabolites to myocardium
What are the more common causes of angina?
Obstructive coronary atheroma
Coronary artery spasm
Coronary inflammation/arteritis
What are some of the less common causes of angina?
Anaemia
LV hypertrophy
Thyrotoxicosis
What are the risk factors for angina?
Smoking DM Hypertension Hyperlipidaemia Obesity FH Male Advancing age
What is the presentation of angina?
Pain- tight band, pressure, heaviness, retrosternal with radiation to neck, jaw, arms
Breathlessness
Excessive fatigue
Near syncope
What classification us used for angina?
Canadian classification of severity
What are the classifications of angina?
I= symptoms on significant exertion II= slight limitation of everyday activity, symptoms walking 2 blocks or >1 flight stairs III= mared limitation, symptoms walking 1-2 blocks, 1 flight of stairs IV= symptoms on any activity
What investigations are done for angina?
FBC, U&Es, LFTs, TFTs HbA1c Lipid profile ECG Exercise tolerance test CT coronary angiography
What is used to confirm diagnosis of angina?
Exercise tolerance test
Diagnostic features= typical symptoms, ST segment depression
What are the indications for CT coronary angiography in angina?
Early or strongly + exercise tolerance test Refractory to medical therapy Diagnosis unclear Young patient Occupation/lifestyle at risk
What are the principles f management of angina?
Lifestyle
Management of comorbidities
Medical
Surgical
What is the medical management of angina?
Symptomatic -nitrates e.g. GTN spray, patches, short or long acting tablets 1. BB 2. Add rate limiting CCB Secondary prevention -aspirin -statin -ACEi
What are the surgical options for angina?
PCI
Coronary artery bypass
