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19 Cards in this Set
- Front
- Back
What will be the effect on myocardial oxygen supply with decrease diastolic pressure?
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Drop in CA perfusion pressure may lead to impaired O2 supply.
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What region of the heart is the most vulnerable to ischemic damage?
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Subendocardium
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Name 2 effects on the LV which can decrease wall stress.
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Decreased filling (i.e. decreased chamer size = hypertrophy), decreased overall size (regression).
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True/False - Ischemia is always caused by either vasospasm (endothelial dysfunction) or atherosclerotic plaques.
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False - Can be a combination of both
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Where do CA's usually have overt stenotic plaques?
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CA's are usually larger and more susceptible to plaque in the proximal segments.
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What is the effect of 70% stenosis? 90%?
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Usually basal level flow is adequate at 70% but increased demand can not be met. At 90% basal levels may not be sufficently met.
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What determines fixed versus variable threshold in Stable Angina?
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The role of alteration in vascular tone in causing angina. Fixed has minimal role while variable has a prominent role.
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What is Syndrome X?
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Symptoms of Angina Pectoris with no evidence of stenoses on coronary angiograms.
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True/False - Large Meals and Cold Weather can induce anginal discomfort in CAD patients.
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True
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Describe possible EKG changes in myocardial ischemia.
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ST segment depressionn and T wave symmetric inversion often appear.
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What is the purpose of an exercise stress test?
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To determine diagnostically or prognostically the level of ischemia.
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What makes a Exercise Stress test positive?
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1. ischemic EKG changes;
2. ST segment depression' 3. Systolic BP DECREASES; 4. Ventricular Arrhythmias present; 5. Patient unable to exercise more than 2 minutes |
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When is Radionucleid imaging used?
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1. EKG abnormalities preclude stress test;
2. discordant results with previous testing modality |
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When is pharmacologic stress testing used? What drugs are often used?
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Indicated in the elderly, those on Beta blockers, and the physically impaired. Adenosine & Dipyrdimaole are vasodilators (steal) or Dobutamine, a Beta agonist, is used to increase demand.
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True/False - Thallium and Technetium are both used in NSPECT for perfusion studies.
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True
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True/False - Coronary Calcium CT Scoring is an independent predictor for incident premature Coronary HD.
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True
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TRUE/FALSE - Lifetime Anticoagulation is necessary for cardiac stents, which are thrombogenic.
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False - only required upto 4 weeks after stent placement.
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What is the main negative in CABG when veins (saphenous) are used instead of arteries (internal mammary)?
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Veins are vulnerable to increased atherosclerosis.
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What 3 factors must be considered when deciding between PCI and CABG?
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Type/Number of stenotic vessels with concomitant current LV contractile function or Diabetes
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