SIHD angina exam questions & answers 2024/2025
what is angina? - ANSWERSchest pain associated with myocardial ischaemia but not myocardial necrosis
what are the main reasons for stable angina? - ANSWERS1. obstructive coronary atheroma -most common
of a small portion of the coronary arter...
what is angina? - ANSWERSchest pain associated with myocardial ischaemia but not myocardial necrosis
what are the main reasons for stable angina? - ANSWERS1. obstructive coronary atheroma -most
common
2.spasm of a small portion of the coronary artery
3.abnormal coronary flow of medium sized
4.reduced oxygen transport ex anaemia
5.increased myocardial oxygen demand
-left ventricular hypertrophy due to pulmonary hypertension, or due to aortic stenosis, or due to
hypertrophic myocardiopathy, or due to thyrotoxicosis(whole body increased metabolic demands)
in stable angina, the symptoms of angina comes on only - ANSWERSwhen there is increased o2 demand
during exercise, anxiety, emotional stress, after a large meal, cold weather
all of these things increase heart rate and breathing rate
so no angina during rest
stable angina symptoms occur when you have - ANSWERS70% of obstruction of the coronary arteries
plaque with thrombus causes - ANSWERSacute coronary syndrome
what are the key characteristics of the pain in stable angina? - ANSWERS-Site of pain (watch for patient
gestures): retrosternal
-Character of pain: often tight band/pressure/heaviness.
-Radiation sites: neck and/or into jaw, down arms.
, -Aggravating e.g. with exertion, emotional stress & relieving factors e.g. rapid improvement with GTN
(glyceryl trinitrate spray) or physical rest.
it is not angina if - ANSWERS1.Sharp/'stabbing' pain; pleuritic or pericardial.
2.Associated with body movements or respiration.
3.Very localised; pinpoint site.
4.Superficial with/or without tenderness.
5.No pattern to pain, particularly if often occuring at rest.
6.Begins some time after exercise.
7.Lasting for hours.
differential diagnosis for chest pain - ANSWERS1.Cardiovascular causes:
Aortic dissection (intra-scapular "tearing"), pericarditis-worse of deep inspiration and leaning forward.
3.Respiratory:
Pneumonia, pleurisy, peripheral pulmonary emboli (pleuritic) worse when deep breath, not on exertion
5.Musculoskeletal:
Cervical disease, costochondritis, muscle spasm or strain-localized, changes in different postitions,
trauma or not tra
how to classify the severity of angina? - ANSWERSI Ordinary physical activity does not cause angina,
symptoms only on significant exertion.
II Slight limitation of ordinary activity, symptoms on walking 2 blocks or > 1 flight of stairs.
III Marked limitation, symptoms on walking only 1-2 blocks or 1 flight of stairs.
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