Exam Bank for Chest pain- Questions Solved Correctly Latest Version 2025
Management of stable angina - Answers Secondary prevention - statin, BP control, DM control, smoking
cessation, diet and exercise
Anti-anginal - nitrate spray, beta blocker or CCB
First line anti-anginal medication - Answers GTN spray
BB or CCB
second line anti-anginal medication - Answers long acting nitrate (isosorbide mononitrate)
Management if angina is not responding to medical management - Answers PCI or CABG
Diagnostic criteria for angina - Answers 1. Typical pain and radiation pattern
2. Precipitated by physical exertion
3. Relieved by GTN or rest
Diagnosis of typical angina - Answers all 3 criteria are met (typical pain, brought on be exercise, relieved
by rest or GTN)
diagnosis of atypical angina - Answers 2 criteria met (typical pain, brought on be exercise, relieved by
rest or GTN)
Investigation for patient with angina - Answers ECG
CT coronary angiography
Key investigation for patient with angina symptoms and no known CV disease - Answers CT angiogram
Key investigation in angina in patient with known CV disease - Answers Functional test e.g. stress ECG
When would you do a stress ECG to investigate angina - Answers Known coronary artery disease
Diagnostic unceratinty following CT andiogram in patient without known CV disease
What investigation would you do in suspected angina where there is diagnostic uncertainty following CT
angiogram - Answers Stress ECG
investigation for angina if there is diagnostic uncertainty following stress ECG - Answers Angiography
Non anti-anginal management of stable angina - Answers Control RF
- Smoking cessation
- BP control with ACEi
, - DM control
- Statin
- Exercise and diet
Examples of agents used to manage stable angina if not controlled with BB or CCB - Answers Long acting
nitrate (isosorbide mononitrate)
Nicorandil
Ranolazine
Ivabridine
When should revascularisation be considered in patients with stable angina - Answers ongoing pain
despite medical thearpy
Can't tolerate medical therapy
What sort of patient would benefit from PCI for their angina - Answers frail and old
single vessel disease
focal disease
What sort of patient would benefit from CABG for their angina - Answers Triple vessel disease
Left main stem disease
Diabetes
Young and fit concurrent valve disease
What is myocardial injury - Answers any situation where there is a rise in troponin
What is myocardial infarction - Answers mycocardial injury due to ischaemia (raised troponin with signs
of ischaemic disease)
Causes of type 2 MI - Answers anaemia
respiratory failure
tachycardia
cardiogenic or hypovolaemic shock
HTN crisis
Anterior STEMI - Answers V1-V4 Left coronary
Management of stable angina - Answers Secondary prevention - statin, BP control, DM control, smoking
cessation, diet and exercise
Anti-anginal - nitrate spray, beta blocker or CCB
First line anti-anginal medication - Answers GTN spray
BB or CCB
second line anti-anginal medication - Answers long acting nitrate (isosorbide mononitrate)
Management if angina is not responding to medical management - Answers PCI or CABG
Diagnostic criteria for angina - Answers 1. Typical pain and radiation pattern
2. Precipitated by physical exertion
3. Relieved by GTN or rest
Diagnosis of typical angina - Answers all 3 criteria are met (typical pain, brought on be exercise, relieved
by rest or GTN)
diagnosis of atypical angina - Answers 2 criteria met (typical pain, brought on be exercise, relieved by
rest or GTN)
Investigation for patient with angina - Answers ECG
CT coronary angiography
Key investigation for patient with angina symptoms and no known CV disease - Answers CT angiogram
Key investigation in angina in patient with known CV disease - Answers Functional test e.g. stress ECG
When would you do a stress ECG to investigate angina - Answers Known coronary artery disease
Diagnostic unceratinty following CT andiogram in patient without known CV disease
What investigation would you do in suspected angina where there is diagnostic uncertainty following CT
angiogram - Answers Stress ECG
investigation for angina if there is diagnostic uncertainty following stress ECG - Answers Angiography
Non anti-anginal management of stable angina - Answers Control RF
- Smoking cessation
- BP control with ACEi
, - DM control
- Statin
- Exercise and diet
Examples of agents used to manage stable angina if not controlled with BB or CCB - Answers Long acting
nitrate (isosorbide mononitrate)
Nicorandil
Ranolazine
Ivabridine
When should revascularisation be considered in patients with stable angina - Answers ongoing pain
despite medical thearpy
Can't tolerate medical therapy
What sort of patient would benefit from PCI for their angina - Answers frail and old
single vessel disease
focal disease
What sort of patient would benefit from CABG for their angina - Answers Triple vessel disease
Left main stem disease
Diabetes
Young and fit concurrent valve disease
What is myocardial injury - Answers any situation where there is a rise in troponin
What is myocardial infarction - Answers mycocardial injury due to ischaemia (raised troponin with signs
of ischaemic disease)
Causes of type 2 MI - Answers anaemia
respiratory failure
tachycardia
cardiogenic or hypovolaemic shock
HTN crisis
Anterior STEMI - Answers V1-V4 Left coronary
