Angina
SUMMARY
(for stable angina. Click here for unstable angina)
Symptoms
Risk Factors*
Investigations
Acute: MONA
Long term: Lifestyle changes (SNAP), prophylatic antihypertensives (BB/CB), nitrates
--END OF SUMMARY--
(for stable angina. Click here for unstable angina)
Symptoms
- Sharp chest pain on exertion*, may radiate to jaw/ arm(s))
- Relieved with rest
- Dyspnoea
- N+V
- Pre-syncope/ syncope
Risk Factors*
- Obesity/ Metabolic syndrome
- Hyperlipidaemia
- Diabetes Mellitus
- Hypertension
- Smoking
Investigations
- Bedside: ECG
- Bloods: FBC+CRP, troponin, BSL, lipid profile
Acute: MONA
Long term: Lifestyle changes (SNAP), prophylatic antihypertensives (BB/CB), nitrates
--END OF SUMMARY--
Definition
Chest pain due to ischaemia of heart mm.
Aetiology
Stable/ Unstable
Usually: Atherosclerotic plaque
Rare: Anaemia, aortic stenosis, tachyarrhythmia, HCM, arteritis
NOTE: Unstable angina is part of ACS
Prinzmetal
Coronary a spasm
Clinical Features
1. Central chest tightness/ heaviness
2. Radiate to arm(s), jaw, neck, chin
3. Dyspnoea
4. Nausea
5. Sweatiness
6. Fainting spells
Investigations
Bedside:
Bloods:
Imaging:
Management
Non pharm:
Complications
*** Unstable angina requires admission and urgent treatment ***
Source
OHCM 8th Ed 2010
RACGP Guidelines for preventive activities in general practice 8th edition 2012
Chest pain due to ischaemia of heart mm.
- Stable (with exertion)
- Unstable (at rest)
- Prinzmetal (vasospasm)
Aetiology
Stable/ Unstable
Usually: Atherosclerotic plaque
Rare: Anaemia, aortic stenosis, tachyarrhythmia, HCM, arteritis
NOTE: Unstable angina is part of ACS
Prinzmetal
Coronary a spasm
Clinical Features
1. Central chest tightness/ heaviness
2. Radiate to arm(s), jaw, neck, chin
3. Dyspnoea
4. Nausea
5. Sweatiness
6. Fainting spells
Investigations
Bedside:
- ECG (Normal/ ST depression)
Bloods:
- FBC (anaemia)
- Troponin (rule out NSTEMI/ STEMI)
- BSL (DM)
- Lipid profile (hyperlipidaemia)
Imaging:
- Cardiac CT
- Coronary angiogram
- Stress echo
Management
Non pharm:
- Lifestyle and diet changes
- Aim: Chol <4.0, TG <2.0, LDL-c <2.0, non HDL-c <2.5, HDL-c >1.0
- Aspirin
- Acute: GTN
- Prophylaxis: beta blockers/ Ca blockers (if BB C/I eg COPD/ asthma)
- Nitrates (give nitrate free period)
Complications
*** Unstable angina requires admission and urgent treatment ***
Source
OHCM 8th Ed 2010
RACGP Guidelines for preventive activities in general practice 8th edition 2012