Angina

1. Describe the classic symptoms of chest pain caused by angina, include:

A. Nature.
B. Location (radiation).
C. Duration.
D. Intensity.
E. Association symptoms.
F. Ameliorating or exacerbating activities.

2. List recommendations for risk factor reduction to prevent or delay coronary artery disease.

3. Identify non-cardiac conditions or diseases which may provoke angina.

4. Describe the clinical presentation of a patient with:

A. Variant (prinzmetal) angina.
B. Silent angina.
C. Unstable or crescendo angina.

5. Develop familiarity with the normal resting EKG and be able to describe EKG changes suggestive of ischemia.

6. Explain how these various classes of therapeutic agents work to beneficially alter the pathophysiology of coronary artery disease.

A. Nitrates.
B. Beta blockers.
C. Calcium antagonists.
D. Antihypertensives.
E. Antiplatelet agents.

7. Describe the patient education one would give patient and family for management of an episode of chest pain.

8. Recognize the impact of work, exercise and general activity (including sex) of CAD on patient and family.

9. Identify the continuous care (historical, physical and lab) parameters that should be monitored in the patient with stable angina.

10. Discuss the principles of stress testing and how it should be utilized in the evaluation of chest pain. Also the different types of stress testing.

11. Be able to describe the risks, benefits and general procedures of cardiac catheterization. Recognize when patients with angina should be evaluated by this method.

12. Compare medical management vs. surgical intervention in angina. Give examples of when each might be appropriate.

13. List the differential diagnosis of chest pain.

Sources:

Family Medicine:  Ambulatory Care and Prevention, Chapter 77, Pages 508-515, Chapter 10, Pages 54-60

Essentials of Family Medicine, Chapter 9, Pages 131-148

Reading Resource:

"ACC, AHA and ACPASIM Develop Guidelines for Angina" Sharon Scott Morey, American Family Physician, October 1, 1999.