Coronary Heart Disease Or (Coronary Artery Disease)

Front 1

Cite 3 treatable risk factors

Back 1

1) Smoking
2) Hypertension
3) Obesity

Front 2

Cite 3 untreatable risk factors

Back 2

1) age
2) Heredity
3) Sex

Front 3

What is Angina Pectoris?

Back 3

Temporary chest discomfort that occurs when the heart is not getting enough blood.

Accompanied by chest pain, dyspnea, anxiousness & sweating

Front 4

Symptoms of Angina?

Back 4

A- Pain
- Squeezing sensation
- Choking sensation
- Upper central abdomen pain
B- Breathlessness and Fatigue
C- Heart burn (in some patients)

Front 5

What are the different types of Angina?

Back 5

1) Stable or exertional angina
2) Unstable angina
3)Variant Angina
4) MIcrovascular Angina

Front 6

What type is the most common form of Angina?

Back 6

Stable Angina

Front 7

What type is the less common form of Angina?

Back 7

Unstable Angina

Front 8

Stable Angina, what indicates worsening of the condition?

Back 8

1) An angina episode that is different from the regular pattern
2) Being awakened at night by angina symptoms
3) Symptoms are more frequent and more severe than usual
4) Angina Symptoms lasting longer
5) Not relieved by Nitroglycerin sublingual

Front 9

People with unstable angina are at increased risk of?

Back 9

1) Heart Attack
2) Severe cardiac arrythmias
3) Cardiac Arrest

Front 10

What are the risk factors for Variant angina?

Back 10

1) Severe atherosclerosis
2) People with heart valve disease or
3) Uncontrolled hypertension
4) Use of cocaine

Front 11

Sufferers frequently feel pain which starts where and spreads where?

Back 11

starts in the chest and spreads to the left arm, jaws or throat

Front 12

What are the complications?

Back 12

1) Increases the risk of developing cardiac arrhythmia
2) Sudden cardiac death occurs most often in people

Front 13

Medications for it?

Back 13

1) Calcium channel blockers
- widen or open the blood vessels & improve blood & oxygen flow to the heart muscle
2) Nitroglycerin
3) Alpha blockers

Front 14

What procedure might be required if severe blockage?

Back 14

Angioplasty procedure

Front 15

Risk Factors of Microvascular angina (chest pain and normal coronary arteries)?

Back 15

1) Smoking
2) Diabetes
3) Hypertension

Front 16

How to diagnose it?

Back 16

1) Exercise-induced angina pectoris
(+ exercise testing)
2) Normal coronary arteriograms

Front 17

New York Association Functional Classification of Angina?

Back 17

Class I: Angina only with unusually strenuous activity
Class II: Angina with slightly more prolonged or slightly more vigorous activity than usual
Class III: Angina with usual daily activity
Class IV: Angina at rest

Front 18

How to diagnose Angina?

Back 18

1) History and Examination
2) Electrocardiogram (with stress test)
3) Blood test (check for cholesterol)
4) Exercise Stress Test
5) Echocardiogram
6) Coronary Angiogram (MOST ACCURATE & EFFECTIVE)

Front 19

Medications for Angina?

Back 19

1) Antiplatelets
2) Beta Blockers
3) Nitrates
4)ACE Inhibitors
5) Statins
6) New Therapies

Front 20

Name a Antiplatelet?

Back 20

Aspirin

Front 21

What does it do?

Back 21

It reduces the ability of blood to clot, making it easier for blood to flow through narrowed heart arteries

Front 22

Effect of Beta Blockers on ischemic heart?

Back 22

Demand is low= Supply Increases

Oxygen deficit
anaerobic metabolism low

Front 23

Surgical treatment?

Back 23

a- Balloon angioplasty
b- Insertion of a stent

c- Coronary artery bypass surgery

Front 24

What is Myocardial Infarction (MI)?

Back 24

Acute coronary artery occlusion leading to necrosis of the myocardium

Front 25

What is the pathogenesis?

Back 25

i. During a heart attack, one of the plaques can rupture and a blood clot forms on the site of the rupture
If the clot is large enough, it can block the flow of blood through the artery

ii. Severe coronary artery vasospasm
iii. Thromboembolism to the coronary artery

Front 26

What are the risk factors?

Back 26

1) Smoking
2) Hypertension
3) Lipid accumulation

Front 27

What are the precipitating factors?

Back 27

1) Vigorous physical exercise
2) Emotional stress
3) A medical or surgical illness

Front 28

What are the symptoms of MI?

Back 28

1) Chest pain (heavy, squeezing and crushing)
- more severe and last longer than angina

Site: involves the central portion of the chest and/or the epigastrium

May radiate to: upper arm, left shoulder, back, neck, lower jaw or stomach

It is often accompanied by weakness, sweating, nausea, vomitting, anxiety and a sense of impending doom

Front 29

More symptoms of MI

Back 29

2) Diaphoresis (Cold sweat)
3) Fullness, indigestion or heartburn

Front 30

How to diagnose it?

Back 30

1) ECG:
Total occlusion of the infarct artery produces
- ST segment elevation
- Deep Q-Wave

Front 31

What is the protein that is released into the blood in large quantities from injured myocardium after AMI?

Back 31

Serum cardiac markers

Front 32

what is two-dimensional echocardiography?

Back 32

It reveals abnormalities of wall motion.

In the emergency, early detection of the presence or absence of wall motion abnormalities by echo can aid in management decisions.

Front 33

LVEF Doppler echocardiography?

Back 33

Useful in the detection of a ventricular septal defect and mitral regurgitation, two serious complications of AMI (acute myocardial infarction)

Front 34

Complications of MI?

Back 34

1) Arrythmias
2) Ischemic
3) Mechanical
4) Embolic
5) inflammatory and immunology

Front 35

What is the most common complication after Acute MI?

Back 35

Dysrhythmias

Related to the formation of re-entry circuits at the confluence of the necrotic and viable myocardium.

Front 36

2 examples of Mechanical Complications?

Back 36

1) Papillary muscle rupture
2) Heart failure

Front 37

Inflammatory and Immunology Compications?

Back 37

Pericarditis

Front 38

What is the therapy of choice for post-MI pericarditis in doses of 650 mg every 4 to 6 hours?

Back 38

Aspirin

Front 39

Why should NSAIDS and corticosteroids should be avoided for 4 weeks after the acute event?

Back 39

These agents may interfere with myocardial healing and contribute to infart expansion.

Front 40

What does the Dressler's Syndrome (post cardiac injury syndrome) consist of?

Back 40

1) persistent low-grade fever
2) chest pain
3) pericardial friction rub
4) Elevated ESR

Front 41

Most important complications of MI (act rapid)?

Back 41

1) arrhythmias
2) Congestive heart failure
3) Tamponade- Thromboembolic disorder
4) Rupture ( ventricle, septum, papillary, muscle)
5) Aneurysm
6) Pericarditis
7) Infection
8) Death- Dressler's Syndrome

Front 42

Why is calling 911 important for treatment?

Back 42

In the initial minutes, a heart attack can also trigger ventricular fibrillation which could lead to sudden death.

Front 43

Emergency treatment is?

Back 43

1) oxygen
2) Control Pain (Morphine, Demerol
3) Antiplatelet therapy (Aspirin)