Chronic Coronary Syndrome (Stable Angina)

Question 1

What is the definition of stable angina?

Answer 1

A predictable and reversible form of myocardial ischemia caused by fixed coronary artery stenosis. Symptoms are reproducible and occur with exertion or stress, improving with rest or nitroglycerin.

Stable angina is characterized by its predictability and response to rest or medications.

Question 2

What are the three characteristics of typical angina?

Answer 2

• Substernal chest discomfort
• Provoked by exertion/stress
• Relieved by rest or nitroglycerin

Typical angina must meet all three criteria to be classified as such.

Question 3

What defines atypical angina?

Answer 3

Meets 2 criteria of typical angina.

Atypical angina does not fulfill all the characteristics of typical angina.

Question 4

What is classified as non-cardiac chest pain?

Answer 4

Meets 1 or none of the criteria for typical angina.

Non-cardiac chest pain is often unrelated to cardiac issues.

Question 5

What are the clinical features of stable angina?

Answer 5

• Retrosternal pressure or tightness
• Precipitated by physical/emotional stress
• Relieved within minutes
• May radiate to shoulders, neck, jaw
• Associated fatigue, exertional dyspnea

These features help differentiate stable angina from other conditions.

Question 6

What are the diagnostic methods for stable angina?

Answer 6

• Baseline ECG
• Stress testing (exercise ECG, stress echo, nuclear perfusion)
• Coronary CT angiography
• Invasive coronary angiography if high risk

These diagnostics assess the presence and severity of coronary artery disease.

Question 7

What lifestyle modifications can help manage stable angina?

Answer 7

• Smoking cessation
• Diet
• Exercise
• Weight loss

Lifestyle changes are fundamental in managing stable angina and overall cardiovascular health.

Question 8

List the types of antianginal therapy.

Answer 8

• Beta-blockers (e.g., metoprolol)
• Calcium channel blockers (e.g., amlodipine)
• Long-acting nitrates (e.g., isosorbide mononitrate)
• Ranolazine (late sodium channel inhibitor)

These medications help alleviate angina symptoms and improve quality of life.

Question 9

What preventive therapies are used for stable angina?

Answer 9

• Aspirin (antiplatelet)
• Clopidogrel (P2Y12 inhibitor)
• Statins (e.g., atorvastatin)
• ACE inhibitors (e.g., ramipril)

Preventive therapies aim to reduce cardiovascular risk and manage underlying conditions.

Question 10

What is the purpose of revascularization in stable angina?

Answer 10

PCI or CABG if symptoms persist or high-risk anatomy.

Revascularization procedures are considered when medical management is insufficient.