Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be talking to you about stable angina.

And you can follow along with written notes on this topic at zero to finals.com slash stable angina or in the cardiology section of the zero toinals medicine book. So let's get straight into it.

When there's a narrowing of the coronary arteries, this reduces the blood flow to the myocardium or

the heart muscle. And then during times of high demand, such as during exercise, there's insufficient

supply of blood to meet the demand.

And this causes the symptoms of angina, which are typically constricting chest pain

with or without radiation to the jaw or the arms.

Angina is stable when symptoms are always relieved by rest or glycerol trinitrate or GTN. It's unstable when the symptoms are always relieved by rest or glycerol trinitrate or GTN.

It's unstable when the symptoms come on randomly while at rest.

Unstable angina is a type of acute coronary syndrome and needs emergency management.

What investigations are useful in angina? Well, a CT coronary androgram is the gold

standard diagnostic investigation. And this involves injecting contrast and taking CT images timed

with the heartbeat to give a detailed view of the coronary arteries, highlighting any narrowing in the coronary

arteries. All patients with angina should have the following baseline investigations, a physical

examination with heart sounds, signs of heart failure, and the body mass index, an ECG, a full blood count,

particularly looking for anemia,

use and ease prior to starting an ACE inhibitor or other medications,

liver function tests prior to starting any statins,

a lipid profile to look for hyperlipidemia,

thyroid function test to check for hypo or hypothyroidism, and a HBA1C and fasting glucose to test for diabetes. And these are all to look for the reversible conditions that are associated with

stable angina and cardiovascular disease. Let's talk about the management of stable angina.

The management described here is based on the

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