GENERAL MEDICINE

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Unstable Angina

This is defined as angina of recent onset which is severe present with minimal exertion or at rest with recent rapid increase in severity and duration or rapid decrease in exercise tolerance. Aggressive management is indicated to reduce the otherwise high risk of infarction. This includes:

  • Bed-rest
  • Aspirin 300 mg daily
  • Removal of exacerbating factors such as cardiac failure, infection, hypertension and arrhythmias.
  • Maximal therapy with B-blockers, calcium antagonists and nitrates (often intravenous).
  • Intravenous heparin anticoagulation (PTT-2x normal).

 

Angiography in those whose pain does not settle, with subsequent options or angioplasty or coronary artery bypass graft.

 

Myocardial Infarction

Myocardial infarction, death of part of the cardiac muscle is the commonest cause of death.

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