3: Ischaemic heart disease & medical treatment Flashcards
Coronary heart disease is a common cause of ___ death.
premature
50% of coronary heart disease deaths are ___.
sudden
Worryingly, 2/3rds of sudden deaths are the (first/second/third) manifestation of coronary heart disease in individuals.
first
What is an alternative name for coronary heart disease?
Ischaemic heart disease
Sudden death in CHD can occur due to ___ which leads to cardiac arrest.
arrhythmia
What is cardiac arrest?
Failure of the heart to pump blood around the body
What is cardiogenic shock?
Inadequate systemic perfusion as a result of cardiac dysfunction
Cardiogenic shock is a consequence of acute __ __.
myocardial infarction
If acute coronary heart disease (e.g MI, arrythmia) is treated quickly, patients can go on to live a __ life with a __ quality of life.
long , good
Coronary heart disease is much more common in (rural / industrial) areas.
industrial
Name a common symptom of CHD.
Chest pain
___ is a clinical diagnosis of chest pain.
Angina
Even though tests can identify obstructive coronary lesions, ___ is the clinical diagnosis.
angina
Which test are you likely to have if you present at a clinic with chest pain?
Coronary angiogram
Why do patients get anginal chest pain?
Myocardial hypoxia
Anginal chest pain is (difficult / easy) for patients to describe.
difficult
Patients may use characteristic ___ to describe their angina to you.
gestures
A patient experiences chest pain, while walking up a hill, which disappears after 30 seconds to a minute. What kind of pain is this?
Stable anginal chest pain
If a patient’s chest pain does not go away after 2 minutes, what are the two possibilities?
- They are having a heart attack
- It’s not related to the heart
What are some characteristics of anginal chest pain?
Pressing, squeezing, heaviness, a weight
Where can anginal chest pain radiate?
Arms, back, neck, jaw, teeth
What can anginal chest pain be associated with?
Exertion, stress, cold wind, after meals
What may relieve anginal chest pain?
Rest, GTN spray
Symptoms associated with chest pain may be coming from which other systems (see slides for more info)?
GI tract
Musculoskeletal
Other cardiovascular causes (pericarditis)
Respiratory (pleuritic chest pain)
What is pericarditis?
Inflammation of the pericardium
Name three acute emergency causes of chest pain.
Myocardial infarction (sense of impending doom, ongoing pain despite loads of morphine)
Pulmonary embolism (breathlessness, dull)
Dissection of aorta (tearing, excruciating, severe then eases)
What is the cause of a tearing, excruciating pain associated with high blood pressure?
Dissection (of aorta)
What type of pain is a clinical diagnosis of CHD?
Angina (chest pain)
What are the advantages of using an exercise ECG to diagnose CHD?
Cheap
Reproducible
What investigation involves giving the patient a radioactive tracer and examining where it travels in heart tissue, based on blood supply?
Perfusion scanning
What investigation involves giving the patient a radioactive tracer and using a CT scanner to examine their coronary arteries?
CT angiography
What gold-standard investigation involves inserting a camera into arteries to identify CHD?
Angiography
How is the risk of death reduced in someone with CHD?
Drugs
Lifestyle changes
Revascularisation
What is the biggest lifestyle recommendation you can give to someone to reduce their risk of CHD?
Stop smoking
(Take exercise, eat a good diet)
If someone presented with chest pain, what would you diagnose them with?
Angina
Can someone have coronary disease without angina and vice versa?
Yes
The presence of CHD can be suggested or confirmed by ___.
tests
Which vessel is commonly occluded in an acute MI?
Left anterior descending
