Stable Angina Flashcards
Define stable angina
Symptomatic, reversible myocardial ischaemia that is induced by exertion and relieved by rest
What is the most common cause?
Atheroma
What are some non-modifiable risk factors of IHD?
FH, Age, ethnicity
What are the key presentations of typical angina?
Constricting/heavy discomfort to the chest, jaw, neck, shoulders or arms
Symptoms brought on by exertion
Symptoms relieved within 5 mins or rest or GTN
What are the key presentations of atypical angina?
2/3 of typical angina presentations
What are the key presentations of non-anginal chest pain?
0-1 of typical angina presentations
What symptoms are associated with angina?
Dyspnoea, nausea, sweatiness, faintness
What is the gold standard
investigation in typical and atypical angina?
CT coronary angiography
What is the first line investigation in IHD?
ECG
What are the differential dignoses?
Other anginas, MI, Pericarditis, PE, Pneumonia
What advice would you give when prescribing GTN?
When you get angina, take 1 spray and wait 5 minutes. If you still have pain take another dose and wait 5 minutes. If you still have pain call an ambulance
When would you prescribe ACEi?
If patient is diabetic
What is PCI?
Percutaneous coronary intervention
What happens during PCI?
Balloon is inflated inside of the vessel in order to open the lumen. A stent is then placed
What is CABG?
Coronary artery bypass graft
How is CABG better/worse than PCI?
Better - less likely to need repeat revascularisation
Worse - more invasive, slower recovery
What are some modifiable risk factors of IHD?
Smoking, poor nutrition, sedentary lifestyle, alcohol, stress, HTN, obesity, DM
What other tests would you do?
Lipid profile, FBC to exclude anaemia, HbA1c to exclude DM
What antiplatelet therapy can you give in IHD?
Aspirin and clopidogrel/ticagrelor
What lipid lowering therapy can you start in IHD?
Statin
What should you control in IHD?
HTN, glucose
What can provide short term symptomatic relief in stable angina?
GTN spray
What can provide long term symptomatic relief in stable angina?
Beta blocker or CCB
What framework is used to calculate risk of a heart attack?
QRISK2 score
