7: ACS, Angina Flashcards
modifiable RFs for CAD
- HTN
- HLD
- DM
- obesity
- cigarettes
- physical inactivity / unhealthy diet
- stress
non-modifiable RFs for CAD
- male
- older than 45
- FHx premature CAD
- African american, hispanic, southeast asian
four non-traditional RFs for CAD
- CKD
- proteinuria
- metabolic syndrome
- inflammatory states
what % of MI’s are painless or atypical symptoms
20%
populations more likely to have atypical or silent MI
women, elderly, diabetics
how do vasodilators vs inotropes/cronotropes work in a cardiac stress test?
vasodilators: coronary A’s are already max dilated at rest, so they receive less flow when whole body is dilated
inotropes: increases myocardial O2 demand
explain stress MPI
- administer IV radioisotope
2. use a special camera system to detect gamma photons
what to observe for during a dobutamine stress ECHO
regional wall abnormalities: hypokinesis, akinesis, or dyskinesis
what % is considered significant stenosis?
70%
if a patient has a past/known ___ on ECG, you cannot diagnose a STEMI
LBBB
there are multiple types of acute MI, but what are Type I and II?
Type I: infarct due to coronary atherothrombosis
Type II: infarct due to supply-demand mismatch
three CABG indications
- 3 vessel disease >70% stenosis
- left main disease
- LV dysfunction
three drugs that improve mortality in MI
- ASA
- B Bs
- ACEi’s
when to use thrombolytics like tPA?
STEMI only
MOA for aspirin, P2Y12 inhibitors, and GPIIb/IIIA inhibitors
- ASA: blocks COX1 and 2
- P2Y12 inhibs: blocks platelet recruitment/activation
- GPIIb/IIIA inhibs: block platelet aggregation
