Stable angina

Question 1

Triggers for stable angina?

Answer 1

Cold weather, heavy meals, exertion, emotional stress

Question 2

How to administer short-acting nitrate vasodilator?

Answer 2

Sit down
Spray 1-2 sprays under tongue then close mouth. To be administered before activities
Can be repeated after 5 minutes

Question 3

1st line therapy for stable angina?

Answer 3

BB or CCB

Question 4

2nd line therapy for stable angina?

Answer 4

Combination of BB or CCB (dihydropyridine if combining e.g., amlodipine, felodipine, DR nifedipine)

Question 5

3rd-line Add-on therapies for stable angina?

Answer 5

Ivabradine (Dihydropyridine CCB if combining)
long-acting nitrate
Nicorandil
Ranolazine

Question 6

4th line therapy for stable angina?

Answer 6

Revascularisation- PCI or CABG

Question 7

How does treatment for stable angina in those with diabetes differ?

Answer 7

Consider ACE-I instead of CCB

Question 8

Use of aspirin in stable angina?

Answer 8

Secondary prevention

Question 9

What is cardiac X syndrome?

Answer 9

Coronary arteries appear normal but anginal symptoms

Question 10

What is not indicated in Cardiac X syndrome?

Answer 10

Secondary prevention medication

Question 11

1st line therapy if BB or CCB CI or not tolerated in stable angina?

Answer 11

Monotherapy of:
- Ivabradine
- Long-acting nitrate
- Ranolazine
- Nicorandil

Question 12

Ranolazine CrCl cut-off?

Answer 12

<30ml/min