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Angina: chest pain (or constricting discomfort) caused by an insufficient…
Angina: chest pain (or constricting discomfort) caused by an insufficient blood supply to the heart muscle
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Stable Angina
Occurs predictably with physical exertion or emotional stress, and is relieved within minutes of rest, or with a dose of sublingual glyceryl trinitrate.
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Unstable Angina
Unstable angina is new (usually within 24 hours) onset angina, or abrupt deterioration in previously stable angina, often occurring at rest. Unstable angina usually requires immediate admission, or referral to hospital.
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Drugs
•Sublingual glyceryl trinitrate (GTN) for the rapid relief of symptoms of angina and for use before performing activities known to cause symptoms of angina.
•A beta-blocker or a calcium-channel blocker as first-line regular treatment to reduce the symptoms of stable angina.
•Second-line treatment such as a long-acting nitrate (for example isosorbide mononitrate), nicorandil, ivabradine, or ranolazine.
•If symptom control is poor on the maximum licensed, or highest tolerated dose of one drug, another drug from a different class should be switched to, or added in.
•If symptom control is poor on the maximum licensed, or tolerated doses of two drugs, referral to a cardiologist (for assessment for revascularization) should be arranged.
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