Acute Coronary Syndromes 1 Flashcards
What is angina pectoris (aka angina)?
- Narrowing of one or more coronary arteries (reduced blood supply) which results in chest pain
- Worsens with exercise
Difference between stable and unstable angina?
Stable:
- No symptoms at rest
- Worsens with exercise
- Partial occlusion
Unstable:
- Symptoms at rest
- Central crushing chest pain
- Partial occlusion
- Pain caused by PLAQUE RUPTURING causing a thrombus/clot
How can you investigate for angina?
- ECG (resting and exercise - shows areas of myocardial infarction)
- Eliminate possibility for other diseases (thyroid, anaemia, valve etc)
- Angiography
- Echocardiography
What happens on an exercise ECG to a patient with angina?
ST segment depression (for a short time)
ECG change resolves when exercise stops
Blood flow through a vessel is proportional to ____ times the radius
8 TIMES THE RADIUS
How can angina be treated?
- Reduce oxygen demands of heart (reduce BP, correct septal defects and failing valves)
- Increase oxygen delivery to tissues (dilate blocked/narrowed vessels, angioplasty, Coronary Artery Bypass Grafting)
What are angina Non-drug therapy options?
- Live within limitations
- Stop smoking
- Graded exercise program
- Improve diet/control cholesterol
What are angina drug therapy options?
- Aspirin (reduce MI risk through thinning blood)
- Hypertension drugs (diuretics, ace inhibitors, B blockers)
- Nitrates
EMERGENCY:
- Glyceryl Trinitrate (GTN) spray
What are angina surgical options?
- CABG (coronary artery bypass graft)
- Angioplasty and stenting
What is peripheral vascular disease and where does it usually occur?
‘Angina’ of the tissues and it usually occurs in the lower limbs
What are the limitations to peripheral vascular disease?
- Limitation of functioning
- Poor wound healing
- Possible necrosis and gangrene
