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CHEST PAIN ?ANGINA

CHEST PAIN ?ANGINA. Raj Chahal. EXCLUDING ANGINA. Non-anginal chest pains Tender / infection / injury continuous or very prolonged and/or unrelated to activity and/or brought on by breathing in and/or

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CHEST PAIN ?ANGINA

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  1. CHEST PAIN ?ANGINA Raj Chahal

  2. EXCLUDING ANGINA • Non-anginal chest pains • Tender / infection / injury • continuous or very prolonged and/or • unrelated to activity and/or • brought on by breathing in and/or • associated with symptoms such as dizziness, palpitations, tingling or difficulty swallowing.

  3. INVESTIGATING • EXERCISE TREADMILL TESTS ARE GONE! • History and examination and risk factors • Assess likelihood of coronary artery disease (CAD) • Choose appropriate investigation • Risk reduction and Treatment

  4. LIKELIHOOD

  5. RISK FACTIORS HIGH RISK • DIABETES • SMOKING • HYPERLIPIDAEMIA • Chol > 6.47 LOW RISK • None of the above

  6. 10-30% CT CALCIUM SCORE ± CT CORONARY ANGIOGRAM • 30-60% FUNCTIONAL TESTING • Looking for stress inducible ischaemia • MIBI SCAN • STRESS ECHO • 60-90% CORONARY ANGIOGRAM

  7. NICE CLINICAL GUIDELINE 95

  8. ANY QUESTIONS?

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