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19 Cards in this Set

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