Angina Flashcards
1
Q
What is the definition of angina?
A
Chest pain due to reduced blood flow to the heart
2
Q
What is the epidemiology of angina?
A
1.2 million men and 900,000 women are living with chronic angina
3
Q
What is the pathology of angina?
A
- Narrowing of coronary arteries
- = ↓ blood supply and O2 to myocardium
- Stable angina: induced by effort
- Unstable angina/crescendo: angina of increasing frequency/severity with minimal exertion or rest, ↑ risk of MI. MEDICAL EMERGENCIES
- Decubitus angina: caused my lying flat
- Varient (Prinzmetal’s angina): caused by coronary artery spasm
4
Q
What are the risk factors/aetiology for angina?
A
- Atheroma
- Anaemia
- Tachyarrhythmias
- Small vessel disease
- Emotion
- Cold weather
- Heavy metals
- Diabetes
- Aortic stenosis
- Hyperlipidaemia
- Thyrotoxicosis
- Smoking
- Obesity
- Family history
- ↑ age
- Male
- Diabetes
- Hypertension
- Cardiac abnormalities – aortic stenosis/hypertrophic obstructive cardiomyophathy
5
Q
What are the signs and symptoms of angina?
A
- Heavy/tight/gripping chest pain centreally/retrosternally whilst exerting – may radiate to neck, jaw or arms, made better with rest/GTN
- Dyspnoea
- Nausea
- Sweatiness
- Faintness
6
Q
What other diseases present similarly to angina?
A
- Acute MI
- Acute pericarditis
- GI reflux
- Aortic dissection
- Pleuritic chest pain (PE)
- MSK pain
7
Q
What investigations are carried out for suspected angina?
A
- BP
- Resting ECG
- Exercise ECG
- CT coronary angiography
- FBC
- Glucose
- Cholesterol
- TFTs
- Troponin/cardiac enzymes
- Myocardial perfusion scintigraphy
- Stress echo
8
Q
What are the surgical treatments for angina?
A
- Coronary artery bypass grafting (CABG)
* Percutaneous transluminal coronary angioplasty (PCTA) – expanding coronary arteries via a balloon
9
Q
What are the pharmacological treatments for angina?
A
- Statin
- Aspirin
- Beta blockers
- GTN spray
- Long acting nitrates – isosorbide
- Long acting calcium antagonists – amlodipine, diltiazem
- K+ channel activators - nicorandil
10
Q
What are the non pharmacological treatments for angina?
A
- Smoking cessation
- ↑ weight loss
- ↑ exercise
