6: CAD Management

Question 1

Name 8 risk factors for CAD.

Answer 1

1. Inactivity
2. Obesity
3. HTN
4. AA
5. Cigarette Smoking
6. High Cholesterol
7. Diabetes
8. Prediabetes

Question 2

_____ is the leading cause of death for both men and women.

Answer 2

Heart disease is the leading cause of death for both men and women.

Question 3

How is coronary artery dominance determined?

Answer 3

The artery that supplies the posterior descending artery (PDA) (a.k.a. posterior interventricular artery) and the posterolateral artery (PLA) determine the coronary dominance.

Question 4

Which artery is the supplier if you have right coronary artery dominance?

Answer 4

Right coronary artery (RCA)

Question 5

Which artery is the supplier if you have left coronary artery dominance?

Answer 5

Circumflex artery (CX)

Question 6

How does supply work with coronary artery codominance?

Answer 6

If the RCA supplies the PDA and the CX supplies the PLA, the circulation is known as “codominant.”

Question 7

Which type of coronary artery dominance is most common?

Answer 7

• Right 60%
• Codominant 25%
• Left 15%

Question 8

What causes CAD?

Answer 8

Damaged endothelium that leads to a fatty streak, fibrous plaque, or complicated lesion.

Question 9

What are 8 causes of chronic epithelial injury leading to CAD?

Answer 9

1. HTN
2. Tobacco use
3. Hyperlipidemia
4. Hyperhomocysteinemia
5. Hemodynamic factors
6. Diabetes
7. Infections
8. Immune reactions

Question 10

What are 6 modifiable risk factors for CAD?

Answer 10

1. Elevated LDL
2. Low HDL
3. Cigarette Smoking
4. HTN
5. Obesity
6. Sedentary Lifestyle

Question 11

What are 3 nonmodifiable risk factors for CAD?

Answer 11

1. Age/Gender (Men >45, Women >55)
2. CHD in male 1st-degree relative
3. CHD in female 1st-degree relative

Question 12

What are the requirements for diagnosis of metabolic syndrome?

Answer 12

• 3+ risk factors:
  
  • Waist >40 in men or >35 in women
  • Triglycerides >150
  • HDL <40 in men or <50 in women
  • BP >130/85
  • Fasting glucose >100

Question 13

Having metabolic syndrome increases your chances of what?

Answer 13

• Heart disease
• Stroke
• Diabetes

Question 14

What diagnostic tests are useful in CAD and why?

Answer 14

• EKG
• CXR
• Transthoracic Echocardiogram

Question 15

Which lab tests would you order for CAD?

Answer 15

1. CBC
2. CMP
3. Lipids/Direct LDL
4. Creatine Kinase (CK)
5. TSH
6. CRP
7. Homocysteine

Question 16

Which lab test?

Used to determine the presence of anemia or infection.

Answer 16

CBC

Question 17

Which lab test?

Used to evaluate renal and liver function (for use when prescribing meds).

Answer 17

CMP

Question 18

Which lab test?

Used to evaluate baseline risk factors.

Answer 18

Lipids/Direct LDL

Question 19

Which lab test?

Used to measure muscle enzymes.

Answer 19

Creatine Kinase (CK)

Question 20

Which lab test?

Baseline needed for the use of statins.

Answer 20

Creatine Kinase (CK)

Question 21

Which lab test?

Used to determine the presence of arrhythmias or other causes of ischemia.

Answer 21

TSH

Question 22

Which lab test?

Used to carry out stratification.

Answer 22

CRP and Homocystein

Question 23

Which lab test?

Evidence suggests these labs are not helpful.

Answer 23

CRP and Homocystein

Question 24

Angioplasty with possible stenting.

Answer 24

Percutaneous Coronary Intervention (PCI)

Question 25

What are 2 types of stents?

Answer 25

• Bare-Metal
• Drug-Eluting (slowly releases drug to stop cell proliferation)

Question 26

Reconfiguring the patient’s blood flow with the patient’s arteries or vein grafts.

Answer 26

Bypass Surgery