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Sp: Coexisting I > 6. Ischemic Heart Disease > Flashcards

6. Ischemic Heart Disease Flashcards

1
Q

prevalence of ischemic heart disease

A

30% of periop pts

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2
Q

ischemic heart disease risk factors

A

genetic
high fat diet
male
smoking
elderly
obesity
diabetes
HTN
sedentary
hypercholesterolemia

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3
Q

ischemia balances

A

O2 delivery and O2 consumption

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4
Q

angina diagnosis

A

retrosternal chest discomfort
crescendo-decrescendo pain over several minutes

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5
Q

angina dermatomes

A

C8-T4

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6
Q

chest wall movement pain indicates

A

costochondritis

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7
Q

stable angina

A

chest pain that doesnt change over 2+ months

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8
Q

stable angina pathophys

A

mild partial occlusion
atherosclerosis

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9
Q

most common cause of stable angina

A

atherosclerosis

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10
Q

stable angina diagnosis

A

stress test
EKG may be normal

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11
Q

chemical stress test

A

atropine
dobutamine
cardiac pacing
adenosine

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12
Q

coronary steal drugs

A

adenosie
dipyridamole

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13
Q

gold standard for angina diagnosis

A

coronary angiography

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14
Q

catheter placement in coronary antiography

A

femoral artery

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15
Q

acute coronary suyndrome

A

worsening O2 demand/supply imbalance

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16
Q

most common reason for ACS

A

focal disruption of atheromatous plaque

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17
Q

STEMI pathoploy

A

CRP and fibrinogen increased

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18
Q

STEMI diagnosis

A

EKG changes
troponin level

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19
Q

troponins elevate within

A

3 hrs of MI

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20
Q

troponin 1

A

> 40 ng/L

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21
Q

troponin T

A

men: > 22 ng/mL
women: > 14 ng/mL

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22
Q

when do you not need an echo for MI

A

if you have EKG evidence

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23
Q

STEMi treatment

A

beta blockers
referfusion (30 mins/12 hrs)
PCI (90 mins/12 hrs)

24
Q

chronic NSETMI treatment

A

stabilize w/statins

25
Q

acute NSTEMI treatment

A

betal blockers
antithombotics
supp O2

26
Q

drug eluting stent reduces

A

neointimal hyperplasia

27
Q

issues with stents

A

thrombosis
bleeding

28
Q

how long does it take to reendothelialize

A

2-3 weeks

29
Q

bare metal reendothelialise

A

12 weeks

30
Q

drug eluting stent reendothelialize

A

up to 1 year

31
Q

DAT

A

aspirin
+
P2Y12 inhibitor (plavix)

32
Q

without stent wait for surgery

A

2-4 weeks

33
Q

BMS wait for surgery

A

30 days-12 weeks

34
Q

CABG wait for surgery

A

6 -12 weeks

35
Q

DES wait for surgery

A

6-12 months

36
Q

MAC risk 4 weeks post PCI

A

10%

37
Q

MACE risk 90 days post PCI

A

4%

38
Q

MACE risk > 90 days post PCI

A

3%

39
Q

apiring increase bleading risk

A

1.5times

40
Q

plavix + aspirin increases bleeding risk

A

2.25x

41
Q

stop clopidogrel/ticagrelor

A

5 days

42
Q

stop prasugrel

A

7 days

43
Q

surgeries you must stop antiplt therapy

A

neuro
aorti aneurysm
prostatectomy

(high bleeding risk)

44
Q

continue DAPT after angioplasty

A

2 weeks

45
Q

continue DAPT after BMS

A

6 weeks

46
Q

continue DAPT after DES

A

12 months

47
Q

when can you give plts after last clopidogrel dose

A

4 hrs

48
Q

when is plt transfusion most effective

A

24 hours after clopidogrel dose

49
Q

predictors of major cardiac complications

A

high risk surgery
MI
CHF
stroke/TIA
IDDM
Cr>2.0mg/dl

50
Q

wait _____ days after MI for surgery

A

60+ days

51
Q

which is better TIVA or VA

A

no difference

52
Q

when do you treat ST segment change

A

> 1mm

53
Q

normal/elevated BP

A

give NTG

54
Q

HR elevated
normal/high BP

A

give esmolol

55
Q
A

Sp: Coexisting I (11 decks)

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