Angina

Data gathering

Clinical management

  • Investigations
    • Bloods
      • FBC, U+E, TFTs, LFTs, fasting glucose, cholesterol
    • ECG
  • Explanation
    • Pain due to reduced blood supply to heart muscle due to narrowing of heart arteries.
    • Heart muscle receives enough blood while resting but it is unable to get enough blood when it requires it e.g. during exertion.
  • Treatment
    • Medications
      • Aspirin 75mg OD
      • GTN
        • Relaxes blood vessels, reducing load on heart
        • 2 sprays under tongue, rest, repeat 5 mins
        • If not pain-free after 3rd use (15 mins) then call ambulance
      • β-blocker
        • Consider if patient requiring regular usage of GTN
    • Refer
      • Rapid access chest pain clinic
    • Lifestyle
      • Smoking cessation
      • Diet, exercise, reduce alcohol
    • Other
      • BP control
      • Immunisations
      • Inform DVLA (cannot hold HGV)
  • Follow-up / Safety net
    • Not controlled by GTN
    • Change in severity, duration or triggers
    • Symptoms worsening despite β-blocker + Calcium channel blocker

Reference