Ischaemic heart disease

• What is ischaemic heart disease also known as?


  Coronary artery disease (disease burden in coronary arteries)
• What is the classification of angina pectoris?


  Typical angina

  • Has all 3…
  • Precipitated by exertion
  • Constricting discomfort in front of the chest, neck, shoulders, jaw or arms
  • Relieved by rest or GTN within about 5 mins

  Atypical angina

  • 2 of above symptoms

  Non-anginal chest pain

  • 1 or fewer of the above
• What are the Inx of IHD?


  Obs

  Full Hx & examination

  ECG

  Bloods (FBC, U&Es, LFTs, CRP, TFTs, lipid profile, HbA1c)

  CXR

  CT angio
• What are the signs & symptoms of IHD?


  Exertional chest pain

  SOB

  Fatigue

  Nausea

  Sweating

  Pre-syncope

  Relief with rest or GTN

  Tachy/bradycardia

  Change in BP

  S4 sound
• What are the possible complications of IHD?


  MI

  Arrhythmias

  HF

  Sudden cardiac death
• What is the treatment & management of IHD?


  Lifestyle advice

  • Pace activity
  • Stop smoking
  • Weight loss/diet changes
  • Alcohol advice
  • Driving advice
  • Cease driving when pain occurs at rest, emotion or whilst driving
  • Driving may restart once symptom control is regained

  Medication

  • Aspirin
  • Statin
  • GTN (sublingual) → take when experiencing symptoms
  • Beta-blocker or Ca+2 channel blocker (1st line)

  Review medication after 2-4 weeks