Stable Angina Flashcards
Define Angina Pectoris
Chest pain characterised by ischaemia but not necrosis.
- chest pain on exertion
- relieved at rest.
Causes?
Most common - CAD
anaemia- reduced oxygen transfer
LVH- increased oxygen demand.
Type of Pain?
Site- retrosternal Onset- exertion, large meal, stress Character- tight band, crushing Radiation- jaw, left arm Timing- get better at rest or GTN
Always pain?
No- can occur with only breathlessness, fatigue or syncope. Diabetics may not feel the pain.
How many levels of severity?
4
I - symptoms on significant exertion
IV- symptoms on everyday activity.
Examination- signs
Tar staining Clubbing Retinopathy Absent or Reduced peripheral pulse and bruits Xanthalasma & corneal arcus
Investigations
Bloods CXR ECG ETT Myocardial Perfusion Imaging CT Coronary Angiogram
Treatment
Control HTN, DIABETES, CHOLESTEROL
Medical treatment
Surgical intervention
Medical treatment for Angina
Statins ACE ASA B blockers- CCB- Ivabridine Nitrates- GTN
Surgical intervention?
Stenting- still need to take meds
CABG - if multi vessel CAD or L main artery
What is the role of Statins?
Lower cholesterol to below 3.5
What is the role of ACE?
To stabilise the endothelium
Role of Beta blockers?
To lower the heart rate
Role of Ivabridine?
Sinus node suppression
Slows heart rate in place of Beta Blockers
Role of Nitrates
Vasodilators
