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Cardiology > 1: Angina > Flashcards

1: Angina Flashcards

(44 cards)

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1
Q

What is angina

A

symptomatic reversible myocardial ischaemia

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2
Q

What are the 4 types of angina

A
  1. Angina Pectoris
  2. Unstable Angina
  3. Prinzmetal Angina
  4. Decubitus Angina
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3
Q

What is stable angina (Angina Pectoris)

A

Chest pain the occurs on a predictable level of exertion

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4
Q

What is unstable angina

A

Angina of increasing frequency or that occurs on minimal exertion or at rest

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5
Q

What is decubitus angina

A

Angina on laying flat

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6
Q

What is prinzmetal (variant) angina

A

Angina due to vasospasm of the coronary arteries

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7
Q

What are 3 risk factors for angina

A
  1. Atheroma
  2. Aortic valve disease
  3. Hypertrophic cardiomyopathy
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8
Q

What are 4 precipitating factors for angina

A

Cold
Emotion
Stress
Heavy Metals

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9
Q

What are risk factors for angina

A 
Smoking
Diabetes
HTN
Age 
Dyslipidaemia
FHx (of CVD in 1st degree relative <55y)
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10
Q

What are the 3 features of angina

A
  1. Heavy/constricting discomfort in the chest, neck, shoulder or arms
  2. Symptoms brought on by exertion
  3. Symptoms relieved by rest or GTN spray
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11
Q

What is typical angina

A

Individual has all 3 features of angina

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12
Q

What is atypical angina

A

Individual has 2 features of angina

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13
Q

If individual has 0-1 features of angina what is it classified as

A

Non angina chest pain

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14
Q

What is the grading system for angina

A

Canadian cardiology society grading of angina

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15
Q

What is class I of the canadian cardiovascular society grading of angina

A

Ordinary activity does not precipitate chest pain

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16
Q

What is class II of the canadian cardiovascular society grading of angina

A

Angina on walking upstairs

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17
Q

What is class III of the canadian cardiovascular society grading of angina

A

Marked impairment of daily activities

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18
Q

What is class IV of the canadian cardiovascular society grading of angina

Study These Flashcards
A

Chest pain at rest

19
Q

When does angina symptoms occur

Study These Flashcards
A

When there >70% occlusion of a coronary artery

20
Q

What type of ischaemia does angina involve

Study These Flashcards
A

subendocardial ischaemia

21
Q

What is first-line investigation for angina

22
Q

What blood tests may be done in angina and why

Study These Flashcards
A

HbA1C
Lipid profile
U+E

23
Q

Why is an ECHO done if angina suspected

Study These Flashcards
A

Ejection fraction is a strong prognostic factor

24
Q

What main Ix is used to diagnose angina

Study These Flashcards
A

CT coronary angiography

25
What are 3 non-invasive functional tests
1. Stress ECHO 2. myocardial perfusion scintigraphy 3. contrast-enhanced MR perfusion scan
26
What is 3rd line imaging for angina
invasive coronary angiography
27
What is the investigation 'work up' for a patient with suspected angina
1. CT coronary angiography 2. Functional tests - Myocardial perfusion scintigraphy - stress ECHO - contrast enhanced MR perfusion scan
28
What is given for symptom relief for angina
Sublingual GTN
29
Explain the usage of GTN
Use before predicted physical exertion or on chest pain. | If no effect after the first dose - give a second dose. If 2nd does not work after 5m call an ambulance
30
What is first-line anti-anginal treatment
B Blocker or Calcium Channel Blocker
31
What does the decision between B blocker or calcium channel blocker depend on
Co-morbidities | Contraindications
32
What is 2nd line angina treatment
B blocker or Calcium channel blocker (add the one that wasn't used originally)
33
What is 3rd line angina treatment
Add one of: - Ivabradine - Isosorbide mononitrate - Nicorandil - Ranolazine
34
What is 4th line angina treatment
Re-vascularisation
35
When is revascularisation considered
If medical therapy thus far has failed
36
What are the two types of revascularisation
PCI | CABG
37
What is PCI
balloon inflated within the stenosed vessel
38
What must be given with PCI and why
12 months of dual anti-platelet (aspirin and clopidogrel) due to increased risk of thrombus formation
39
What does a CABG involve
Open heart surgery
40
What is the benefit of a CABG
Lower probability of needing re-vascularisation
41
What medication should all patients with angina be given as secondary prevention
- Aspirin (75mg) | - Statin
42
What lifestyle advice is given for secondary prevention of angina
Weight loss Maintain physical activity Cardioprotective diet
43
When is an ACEi given
If angina and diabetes
44
What are 3 complications of angina
MI Sudden cardiac death Severe arrhythmias

Cardiology (13 decks)

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