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Cardiovascular > angina > Flashcards

angina Flashcards

1
Q

what is angina in a physiolical meaning

A

where there is miocardial ischemia but no miocaridla necociss

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2
Q

what is stable angina causes

A

myo cardium blodo reduction
obstucive coronary artery atheroma
spasm of section of coronary artery
abnormal coronary artery flow

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3
Q

when does myocardial oxygen demand increas

A

during increased heart rate and blod pressure for example exercise, anxiety, stress, after a large meal

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4
Q

can anemia cause angina

A

very rarley

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5
Q

what change in the heart can rarely cause angina

A

left venticular hypertropy- due to persisttn hypertension and aortic stenosis

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6
Q

what change in teh thryprosi cland cause sometimes cause angina

A

hyperthyroidsm

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7
Q

most common cause of angina

A

coronary athermoa

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8
Q

what percent lumen obsution in teh coronary artery is need for angina

A

70%

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9
Q

wher is teh site of pain for angian

A

behind th breast bone

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10
Q

what is the character of pain for angina

A

tight band, pressure and heavies,

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11
Q

what is the radiation for angia

A

neck, jaw, down arms

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12
Q

how long should angina last for

A

short time

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13
Q

shoudl angina be stabing

A

no

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14
Q

is angina assoisted with respiration

A

no

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15
Q

what is the cardo vasular causes of angina

A

pericarditis, aortic dissection - intra scapular teraing

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16
Q

what is the respirator differetion of angina

A

pneumonia, pleurisy, peripheral pulomonary emboli

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17
Q

what is the musculoskeletal causes of angia

A

cerviacl disease, costochondritis, musle spasms,

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18
Q

what is the gi causes of angina

A

gastro-oesophageal reflux, oesophagal spasm, peptic ulceration, biliary colic , cholecysts, pancreatitis

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19
Q

non pain symptos of angina on exertion

A

near fainting on exerction, breathlessnes of exerciton, excessive fatigue on exertion

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20
Q

what is the classification for stabel angina

A

1- symptons only on signicfacnt exercis
2 - simpton on walking 2 blocks or more than 1 flight of stairs
3 - symptoms on walking 1-2 bloks or 1 flight of starts
4 - symptoms on any activity e.g. getting dressed

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21
Q

what are some non modifiable factors that cuaes angina

A

age, gender, family histroy, genetic factors

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22
Q

what are some modifiale causes of angina

A

smoking, lifestye - exercise and deit
diabetes melliutis
hypertension
hyperlipdiameia

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23
Q

what are some periphal sidigs of stable angia on examination

A

tar on fingers
obesity
xanthelasma (lipid plaus in the lower eye) corneal arcus - white circle around lower cornea
abdominal aortic aneurism, absent or reduced peripheral pulse
diabetes retrinopathy , hypertensive reinopathy on fundoscopy

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24
Q

what is the signs on examinaro of exacrtbation

A

pallor o anemia
tachycaria, tremor, hyper relixca of hyperthryoridsm
ejection systolic murmor, platu of puse of aortic stenosis
pansystolic muro of mitrla regution
heart failure - base crakse , elaved jvp, peripheral odema

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25
Q

what blood test is done for stable angina

A

fbc, lipid profiel, fasting glucose, elelectrolites, liver and thyroid tests

26
Q

what test can be used for angia

A

cxr, ecg, exercise tolerance tests , myocardial perfusion imaging, CT of coronary angiogram

27
Q

what is seen of a ecg with angina

A

often norma
my see patholoca q waves from previous mi
left venticarl hypertropi, st segmtn depressoin, strain pattern

28
Q

what is an exercise totlaer test

A

walk for long enout to prodcecv stres
leading to st segment depression

29
Q

what is myocaridal perfusion imagaing

A

where a radial nuclide traceer is injected at peak stress, and on is injected a rest
there is a comparison between the tow

30
Q

what happns in myocari perfusion infaing if the tracer is seen at res but not after stress

A

ischaemia

31
Q

what happens if teh tracer is seen no at rest or after stress in myocaridl perfusion imaging

A

infraction

32
Q

what is a down side to myocardio perfusion imagaing

A

it is exspencise

33
Q

what is ct cornary angioga

A

using a ct scanner to make a 3d picter of a heart

34
Q

when shoud you do a angiogram

A

if ther is early or strong postive ett
angian does not respond to medal therapy
diagnosis is not clear after non invasive tests
young cardiac patents due to work/ life effects
occupation or lifestys with risks, e.g. drivers

35
Q

what is the result of cornaory angiogram

A

shows what cornary antomy sies are damged, enabling a decision on what treat options are possible
what treatment is needed ie.e mediation or perction coronary intervention or cabg

36
Q

hat is cardica caterhisation started from

A

the femoral or radial artery

37
Q

what assiant also goes inwith catherter

A

radio opaque conratst

38
Q

what is the role of statinq

A

reduce ldl cholestrol deposio in atheroma, stabloise atheoma plauqes

39
Q

what is the role of ace inhibitors

A

stabilises endothemlim and reduces plaque ruptures

40
Q

what is the role of aspirin

A

protects endotheili and reduces platel activation,

41
Q

what is the goal for resting heart rate on beta blocker and calum chana inhibotrs

A

60 beats per min

42
Q

what is the role of beta blokers

A

reeuce myocardial work, have antiaryphic effects

43
Q

centrely ca channel blokers examples

A

ditizem and verapamil

44
Q

what are ik channel bloker exampels

A

ivabridine

45
Q

what is are peripherlly acting calcium channel bloker examples

A

amlodipine and felodipine

46
Q

what is the role of nitrates

A

vasodilation

47
Q

what is nitrates in the for of

A

long acing tables, pathces of subliqual gtn spray

48
Q

what is an example of k+ chnnel blokers

A

nicoradil

49
Q

what is percutaneous coronary intervetion

A

stening and angioplay

50
Q

what drus should be on after a stnent is inserted

A

aspirin and clopidogrel

51
Q

what is teh rsik of restenois with stens

A

about 10-15% with bare metal and less than 10 % with drug elutig stnstion

52
Q

what is caba

A

cornary arery bypass surgyr

53
Q

what percent of people die from cabg

A

1.3

54
Q

what percent of peopl have a q wave mi

A

4%

55
Q

what percent of cabg are sympon free after 5 years

A

80%

56
Q

who can have cabg

A

those with great than 70% stenosis, signicat proial three vessel coronary artery disease
two vessel coronary after diase that includes signic stonds of left anterio descntio corary artry and with ejection fraction less than 50%

57
Q

how long must patiens be on diseea modifiy meida after a vein grat

A

10 years

58
Q

what are teh two types of bypas gragq

A

free grats and fxied grsts, free ar longer, nrmaly from left subcaltivan

59
Q

what vein is used incoronary arter bypass graftin

A

long saphenous vein

60
Q
A

Cardiovascular (37 decks)

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