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Angina Pain in chest, neck, shoulders, jaw or arms caused by an…
Angina
Pain in chest, neck, shoulders, jaw or arms caused by an insufficient blood supply to the myocardium
Differential diagnosis
Cardiac
Acute coronary syndrome
Dissecting thoracic aneurysm
Pericarditis
Cardiac tamponade
Cardiac failure
Arrhythmia
Respiratory
P.E
Pneumothorax
CAP
Asthma
Lung collapse
Lung CA
Pleural effusion
GI
Acute Pancreatitis
Oesophageal rupture
Peptic ulcer/GORD/oesophagitis
Acute Cholecystitis
MSK
Herpes zooster
Symptoms
SOB
Chest/neck/shoulders/jaw/arm pain
Relieved by rest/ GTN spray within 5mins
Atypical angina
two of the above features + gastro discomfort
Nausea
Causes
Coronary artery disease
Atherosclerotic
Valve ddisease
Hypertrophy obstructive cardiomyopathy
Hypertensive heart disease
Complications
Stroke
Myocardium infarction
Unstable angina
Sudden cardiac death
Anxiety & depression
Reduced quality of life
Risk factors
Non-modifiable
Over 50
Male
FmHx of CVD
Ethic background
Modifiable
Smoking
Low HDL cholesterol
High level of non HDL cholestrol
Lack of exercise
Unhealthy diet
Alcohol above recommended intake
Overweight/obesity
Co-morbities
Hypertension
Diabetes
CKD
Dyslipidaemia
AF
RA
Lupus
Influenza
Mental health problems
Peridonitis
Management
Rapid access to CP clinic
12-lead ECG
Lifestyle advice
Cardiac risk assessment
Medication
GTN
Strong WSG if GTN not relieving symptoms
Beta-blocker
Rate limiting calcium blocker
Amlodipine (HF patients)
Secondary prevention
Antiplatelet
ACE
Statin
Hypertensive treatment if required.