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
what blood test is done for stable angina
fbc, lipid profiel, fasting glucose, elelectrolites, liver and thyroid tests
26
what test can be used for angia
cxr, ecg, exercise tolerance tests , myocardial perfusion imaging, CT of coronary angiogram
27
what is seen of a ecg with angina
often norma my see patholoca q waves from previous mi left venticarl hypertropi, st segmtn depressoin, strain pattern
28
what is an exercise totlaer test
walk for long enout to prodcecv stres leading to st segment depression
29
what is myocaridal perfusion imagaing
where a radial nuclide traceer is injected at peak stress, and on is injected a rest there is a comparison between the tow
30
what happns in myocari perfusion infaing if the tracer is seen at res but not after stress
ischaemia
31
what happens if teh tracer is seen no at rest or after stress in myocaridl perfusion imaging
infraction
32
what is a down side to myocardio perfusion imagaing
it is exspencise
33
what is ct cornary angioga
using a ct scanner to make a 3d picter of a heart
34
when shoud you do a angiogram
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
what is the result of cornaory angiogram
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
hat is cardica caterhisation started from
the femoral or radial artery
37
what assiant also goes inwith catherter
radio opaque conratst
38
what is the role of statinq
reduce ldl cholestrol deposio in atheroma, stabloise atheoma plauqes
39
what is the role of ace inhibitors
stabilises endothemlim and reduces plaque ruptures
40
what is the role of aspirin
protects endotheili and reduces platel activation,
41
what is the goal for resting heart rate on beta blocker and calum chana inhibotrs
60 beats per min
42
what is the role of beta blokers
reeuce myocardial work, have antiaryphic effects
43
centrely ca channel blokers examples
ditizem and verapamil
44
what are ik channel bloker exampels
ivabridine
45
what is are peripherlly acting calcium channel bloker examples
amlodipine and felodipine
46
what is the role of nitrates
vasodilation
47
what is nitrates in the for of
long acing tables, pathces of subliqual gtn spray
48
what is an example of k+ chnnel blokers
nicoradil
49
what is percutaneous coronary intervetion
stening and angioplay
50
what drus should be on after a stnent is inserted
aspirin and clopidogrel
51
what is teh rsik of restenois with stens
about 10-15% with bare metal and less than 10 % with drug elutig stnstion
52
what is caba
cornary arery bypass surgyr
53
what percent of people die from cabg
1.3
54
what percent of peopl have a q wave mi
4%
55
what percent of cabg are sympon free after 5 years
80%
56
who can have cabg
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
how long must patiens be on diseea modifiy meida after a vein grat
10 years
58
what are teh two types of bypas gragq
free grats and fxied grsts, free ar longer, nrmaly from left subcaltivan
59
what vein is used incoronary arter bypass graftin
long saphenous vein
60