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38 Cards in this Set
- Front
- Back
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What is the staging of coronary artery disease?
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I: Initial lesion; 1st decade
II: Fatty streak; lipids accumulate III:intermediate; more lipid pool, start to see foam cels IV: Atheroma; more lipid pools, can be overt V: Fibroatheroma; lipid core with fibrotic cap. SM present; can be overt. VI: Erosion/dirupted plaque |
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What is the definition of classic angina?
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Transient discomfort of pain sensation occuring in the precordium, provoked by physical or mental stress. Relievable by nitroglycerin
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What is the definition of atypical angina?
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Transient discomfort/pain that is lacking 1 or more of the criteria of classic angina
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What is the definition of angina equivalent?
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Sensation of dyspnea, fatigue, or weakness as a manifestation of cardiac ischemia
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In general, how do older px present with coronary syndromes? Younger?
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Older: SOB
Younger: chest pain |
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What is the clinical presentation of classic angina?
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ST segment depression
Provoked by physical, mental stress Lasts for less than 15 min Tx. by beta blockers, nitrates, ca channel blockers |
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What is prinzmetal angina?
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Idiopathic
Vasospasm of SM around arteries Common in postmenopausal women |
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What metabolic factors have an impact on vascular tone?
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Reduced O2--> vasodilation
Reduced ATP --> vasodilation |
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What endothelial factors have an impact on vascular tone?
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NO --> vasodilation
Prostacyclin --> vasodilation Endothelin-1 -->vasoconstriction |
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What neural factors have an impact on vascular tone?
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Alpha adrenergic receptors --> vasoconstriction
Bet andrenergic receptors --> vasodilation |
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What measure is used to approximate coronary perfusion pressure?
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Diastolic blood pressure
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Why doesn't blood flow into the coronarys during systole?
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External compression of the arteries
Venturi effect: blood is going past the arteries too fast |
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What compound in the endothelium is responsible for vasodilation? What does this effect outweigh?
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NO
Alpha vasoconstriction |
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What is the quality of angina?
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Tight
Constricting Not pleuritic Radiation to jaws, arms Heaviness Not stabbing Dull, not sharp SOB, sweaty |
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What can provoke angina?
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Exertion, emotion
Cold air Large meal |
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How long does angina generally last?
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seconds < x < 10-15 min
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How does one normally go about treating angina?
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Nitroglycerin
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What does an EKG show in a px. with angina?
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ST-segment depression
or T-wave flattening/inversion |
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What does the EKG of a person look like during angina?
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What does the EKG of a person look like during angina?
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What signs on the stress test show severe CAD?
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Change in EKG happens in 1st 3-6 min or persists
Large ST depression Systolic BP falls during exercise High grade arrhythmias |
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What tests can you do while doing the stress test/
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Myocardial perfusion scintigraphy
Echos |
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What sort of stress tests can you do for people who aren't able to exercise? What do you administer?
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Pharmacologic
1. Administer an agent that will cause the heart to work (adenosine 2. Administer a radioactive agent (thallium) 3. Image the heart; see where the tracer is. |
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What are the factors that you need to take care of to cure chronic chd?
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Hyperlipidemia
HTN DM Smoking Poor exercise habits |
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What are ways to reduce shear stress on vessels?
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Beta blockers
Regular exercise |
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What are ways to reduce the thrombogenicity of blood?
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Asprin
Clopidogrel |
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What are ways to reduce the vasoreactivity of vessels?
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Beta blockers
Nitrates Calcium blockers No smoking Control lipids (statins) |
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What is the preferred vessel for surgery?
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Left internal mammary artery
Doesn't have as high of risks for thrombi forming inside |
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What are ways to improve the symptoms from angina?
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Beta blockers
Nitrates Calcium channel blockers Statins PCI CABG |
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What are the ways to prevent acute ischemic syndromes in angina patients?
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ASA
Beta blockers Lipid lowering agents Stopping smoking ACE inhibitors |
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What are ways to prolong life in px with angina?
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CABG
Lipid lowering drugs |
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What are ways to reduce shear stress on vessels?
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Beta blockers
Regular exercise |
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What are ways to reduce the thrombogenicity of blood?
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Asprin
Clopidogrel |
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What are ways to reduce the vasoreactivity of vessels?
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Beta blockers
Nitrates Calcium blockers No smoking Control lipids (statins) |
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What is the preferred vessel for surgery?
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Left internal mammary artery
Doesn't have as high of risks for thrombi forming inside |
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What are ways to improve the symptoms from angina?
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Beta blockers
Nitrates Calcium channel blockers Statins PCI CABG |
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What are the ways to prevent acute ischemic syndromes in angina patients?
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ASA
Beta blockers Lipid lowering agents Stopping smoking ACE inhibitors |
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What are ways to prolong life in px with angina?
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CABG
Lipid lowering drugs |
