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Ii right coronary artery anginaatrest

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Unformatted text preview: Cardiovascular Society ventricular? ii. Right coronary artery Angina at rest Prinzmetal (Variant) angina Prinzmetal Most commonly due to vasospasm May not be related to activity Pain is identical to anginaNot as common as stable angina May lead to a heart attack if vasospasm is prolonged Normal coronaries on angiography BVs normal Diagnosis Diagnosis Clinical Features Examination Risk Factor Profile­ Glucose, lipids ECG­rest and stress Stress = treadmill –det. if low, intermediate or high risk Echocardiogram, Nuclear cardiology Gold standard Coronary Angiography risks (1/1000(dyes in vessel) – invasive + stroke/heart attack) Xanthoma – yellow nodule/plaque on skin Risk Factor assessment Risk Factor assessment Non invasive tests Rest ECG Exercise ECG Echocardiogram Functional Exercise/ Dobutamine Echocardiogram Exercise/ Dobutamine/ Persantin Nuclear SPECT Non Functional CT angiography Computed Tomography Invasive tests Persantin = vasodilator (90% specifity) Angiogram Treatment Treatment Risk factor / Lifestyle Modification Aspirin and/or clopidogrel Beta blockers Reduce contractility/work (↓burden) Nitrates­ short and long acting Dilate vessels Calcium channel blockers ACE inhibitors 2 Lipid lowering agents nd 2nd line line Revascu...
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