Pharmacological Treatment Of Angina Flashcards
(59 cards)
Where does the pain come from in angina?
Heart muscle- caused by the lactic acid produced during anaerobic respiration
Stimulated myocardial pain receptors which send messages via cardiac nerves and upper posterior nerve routes to the brain
What are the symptoms of angina?
- Feeling of cramping and severe constriction in the chest
- referred pain- jaw, shoulders, neck and arms
- may be associated with shortness of breath, sweating and nausea
What are the key facts of chronic stable angina?
Affects around 2-4% of the population in western countries
Associated with estimated annual risk of death of 1-2%
Estimate that 1.3 million people in the UK are living with angina
What are the treatment aims of angina?
To enhance quality of life through reduction of symptoms
To improve prognosis and prevent complications
Well tolerated and they cause minimal side effects
What are the four types of angina?
Stable, unstable, prinzmetal and micro vascular
What are the causes of stable angina?
Attributed to myocardial ischaemia
What causes unstable angina?
Complications from stable angina
What causes prinzmetal angina?
Spasm in coronary arteries
What causes coronary vasospasms?
Cocaine use
What is stable angina caused by?
Narrow artery lumen -> restricted blood flow to the area of myocardium it supplies-> oxygen it receives is insufficient when the heat has to work harder-> anaerobic respiration -> pain
How is stable angina relieved?
Rest or taking medication
What’s the difference between stable and unstable angina?
Stable follows a set pattern, unstables predictable
Stable is relieved by rest and medication and unstable isnt
What causes unstable angina?
Clot formation occluded artery-> critical reduction in blood flow so oxygen supply is inadequate even at rest
When does prinzmetal angina occur?
At rest or through the night
How long does prinzmetal angina last?
5-15 mins
How common is prinzmetal angina?
Rare (1 in 100)
What are associated symptoms of prinzmetal angina?
Heartburn, nausea, sweating, dizziness, palpitations, migraines
What causes microvascular angina?
Impaired coronary circulation due to coronary microvascular dysfunction from abnormal vasodilation or increased vasoconstriction
Why can microvascular angina not be diagnosed early?
Coronary microvasculature cannot be directly imaged in vivo
What can be used to asses coronary microvascular blood flow?
PET scan or cardiac magnetic resonance
What is the definition of angina?
An imbalance between demand and supply of oxygen to the heart
What two types of angina cause decreased coronary blood flow?
Vasospasm (prinzmetal) and thrombus blockage (unstable)
What type of angina causes an increased oxygen requirement?
Fixed stenosis (chronic stable angina)
What are the three precipitating factors of angina?
Increased sympathetic activity, contractility and vasoconstriction
