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Cardiovascular Block > Stable Angina and Ischaemic Heart disease > Flashcards

Stable Angina and Ischaemic Heart disease Flashcards

1
Q

What are some of the differential diagnoses for stable angina?

A 
Aortic dissection
Pneumonia
Pleurisy
Gastro-oesophageal reflux 
etc
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2
Q

What is the main pathophysiological reason behind stable angina?

A

Oxygen and myocardial demand mismatch

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3
Q

What is the oxygen and myocardial demand mismatch mainly down to?

A

Reduction in coronary blood flow to myocardium due to the atheroma

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4
Q

What can an atheromatous plaque rupture lead to?

A

Thrombosis

Acute coronary syndromes

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5
Q

What is the name of the angina severity scale?

A

Canadian classification

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6
Q

What does stage 3 angina severity signify?

A

Marked limitation

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7
Q

What are the main risk factors for stable angina?

A 
Age
Smoking
Lifestyle
Diabetes
Hypertension
Hyperlipidaemia
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8
Q

What are the signs of stable angina on examination?

A

Tar staining on fingers
Xanthalasma
Corneal arcus

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9
Q

What are the signs of exacerbating angina?

A 
Pallor of anaemia
Tachycardia
Pansystolic murmur
Elevated JVP
Peripheral oedema
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10
Q

What are the investigations indicated for suspected stable angina?

A

ECG (May show ST depression)
CXR (To eliminate other causes)
Exercise tolerance test (To produce anginal symptoms on exertion)
Myocardial perfusion imaging (Shows localisation and size of affected area)
Invasive angiography

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11
Q

What is the medical treatment indicated in the treatment of stable angina?

A

Statins (If total cholesterol is > 3.5mmol/L)
ACEIs (If increased CV risk and atheroma)
Aspirin (reduction of mortality)
Beta-blockers (reduces symptoms)
CCBs (To reduce HR)
Nitrates and CCBs (Produce vasodilation)

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12
Q

How do beta-blockers work?

A

Block adrenaline’s physiological response

Increase threshold at which angina occurs and produces symptoms

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13
Q

What is PCI?

A

Stenting and angioplasty

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14
Q

What is the effect of PCI?

A

Squashes atheromatous plaques into wall with the balloon and stent

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15
Q

What drugs are given alongside PCI?

A

Aspirin

Clopidogrel

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16
Q

What is seen as the best option for stable angina?

A

Coronary artery bypass graft

17
Q

What are the potential adverse drug reactions for beta-blockers in angina treatment?

A 
Fatigue
Lethargy
Impotence
Bradycardia
Bronchospasm
18
Q

What are the adverse drug reactions for CCBs?

A

Ankle oedema
Headache
Flushing
Palpitation

19
Q

How do nitrates relieve angina?

A

Arteriolar dilatation - reduce cardiac afterload and myocardial oxygen demand

20
Q

What is the choice of the antiplatelet agent in angina therapy?

A

Low dose aspirin

Cardiovascular Block (24 decks)

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