Stable angina Flashcards
Symptoms of angina
constricting chest pain with or without radiation to jaw or arms
when is angina stable?
symptoms relieved by GTN or rest
Gold standard diagnostic investigation
CT coronary angiography
What is a CT coronary angiography?
inject contrast and take CT images timed with heartbeat
baseline investigations
physical exam eg heart sounds, heart failure signs, BMI
ECG
FBC, U&E (before ACEI), LFT (prior to statins), TFT, HBA1c and fasting glucose, lipids
RAMP - management of angina
refer to cardiology
advise about diagnosis, management and when to call ambulance
medical treatment
procedural/surgical management
immediate symptom relief
GTN then repeat after 5 mins
still there - call ambulance
long term symptomatic relief
beta blocker - bisoprolol 5mg daily
CCB - amlodipine 5mg daily
or nicorandil, ivabradine etc
What intervention is offered to those with proximal/extensive disease on CT angiography?
PCI with coronary angioplasty
what is PCI with coronary angioplasty?
dilating the blood vessel with a balloon
inserting a stent
how is PCI with coronary angioplasty done?
catheter into patients brachial or femoral artery, up to coronary arteries by x-ray/contrast guidance
who may be offered CABG?
severe stenosis
what does CABG involve?
opening chest along sternum, graft vein from leg and sew on to affected coronary artery to bypass stenosis
what vein is used in CABG?
great saphenous
