Angina Flashcards
What causes angina
Insufficient blood flow to heart muscles due to decreased o2 supply or increased o2 demand
What can decrease myocardial o2 supply
Coronary artery disease - atherosclerosis, spasm, vasculitic disorders, post radiation therapy
Severe anaemia
What can cause an increase in myocardial o2 demand
Left ventricular hypertrophy - hypertension, aortic stenosis, aortic regurgitation, hypertrophic cardiomyopathy
Right ventricular hypertrophy - pulmonary hypertension, pulmonary stenosis
Rapid tachyarrhythmias
What are the 3 characteristics associated with stable angina
1 central chest discomfort lasting 5-10 mins
2 provoked by exertion or emotional stress
3 relieved by rest or nitrates
How many of the 3 angina characteristics are needed for a diagnosis of atypical and typical angina
Atypical - 2
Typical - all 3
What does anatomical testing in angina diagnosis look for evidence of
Obstructive disease
What does functional testing in angina diagnosis look for evidence of
Ischaemia
Anatomic testing used in angina diagnosis
CTCA
Functional testing used in angina diagnosis
Exercise tolerance time
SPECT
stress echo
Stress cMR
What medications can be used to increase o2 delivery to heart by increasing coronary flow
Nitrates
CaBs
Nicorandil
Revascularisation
How can o2 demand of the heart be decreased therapeutically
Decr heart rate
Decr left ventricular wall tension
Decr contractility
Modify energy metabolism
Which medications can be used to decr heart rate
Beta blocker
Ivabridine
Which medications can be used to decr left ventricular wall tension
Beta blockers
Nitrates
Nicorandil
CaBs
Ranolazine
Which medications can decr heart contractility
Beta blockers
CaBs
How can energy metabolism be modified
Trimetazidine
