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Cardiovascular 2 > Angina Pectoris > Flashcards

Angina Pectoris Flashcards

1
Q

This is a strangling/uncomfortable sensation in the chest and neighboring anatomic structures caused by myocardial ischemia.

A

Vagina pectoris

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2
Q

This type of vagina is predictable, transient, and elicited by exertion or emotional stress.

A

Chronic stable vagina

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3
Q

What forms in the coronary arteries to cause chronic stable angina?

A

Atheromatous plaque

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4
Q

In chronic stable angina, there is endothelial dysfxn, which results in the inability of the vessels to do what?

A

Dilate

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5
Q

This subtype of chronic stable angina is when there is a constant amount of physical activity that’s required to induce angina.

A

Fixed threshold

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6
Q

What are the alterations to cause the variable chronic stable angina?

A

vascular tone over the sites of fixed stenosis

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7
Q

This type of vagina results when some1 with stable angina starts to have sudden increases in tempo and duration of ischemic episodes that occur with lesser degrees of exertion

A

Unstable vagina

lol ok ill stop.

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8
Q

Unstable vagina (I DIDNT STOP HAHAHA) is usually a precursor to what gnarly condition?

A

MI

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9
Q

Unstable angina and MI are classified as what “syndromes”?

A

Acute coronary syndromes

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10
Q

What happens to the atherosclerotic plaque to cause platelet aggregation and thrombosis in acute coronary syndromes?

A

rupture

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11
Q

This type of angina is when a pt gets episodes of focal coronary artery spasm in the absence of overt atherosclerotic lesions.

A

Variant (prinzmetal) angina

SO F-ING METAL

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12
Q

Which nervous pathway may be increased in activity in combo with endothelial dysfxn to cause variant angina?

A

SANS

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13
Q

True or False: variant angina occurs typically at rest.

A

True!

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14
Q

True or False: typically, angina presents with 5-10 minutes of intense pain in the chest.

A

False. It’s usually a feeling of pressure, discomfort, tightness, burning, or heaviness

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15
Q

This sign is indicative of angina, where the pt puts their fist over their chest when describing the discomfort.

A

Levine sign

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16
Q

What are the accompanying Sx of angina?

A

tachycardia, disaphoresis, nausea, dyspnea, transient fatigue, and weakness.

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17
Q

This is the condition where there are episodes of cardiac ischemia, but the pt doesnt experience any perceptible pain or discomfort.

A

Silent ischemia

18
Q

What % of pts with stable angina can have silent ischemia?

A

40%

19
Q

This is the syndrome when pts have the Sx of typical angina pectoris, but there is NO EVIDENCE of significant atherosclerotic coronary stenosis on angiograms.

A

Syndrome X

queue the X files music

20
Q

What is the most likely problem with the small coronary vessels to cause Syndrome X?

A

inadequate vasodilation

21
Q

What is the most important part of the examination to find out which type of angina the pt has?

A

History

22
Q

What 3 things must u ask about for the type of discomfort they feel?

A

percipitants, remission, frequency

23
Q

What will you see on physical examination during an angina attack?

A

tachycardia, HTN, mitral regurg, palpatory ventricular contraction abnormalities, S4 gallop

24
Q

Which test must u do during an angina attack?

A

EKG

25
Q

What will happen to the ST segment during subendocardial ischemia?

A

depressions (with horizontal or downsloping)

26
Q

What will happen to the ST segment during transmural ischemia?

A

ST elevation

27
Q

What is the criteria for a + stress test for cardiac ischemia?

A

EKG showing ST depression

28
Q

This is the test u can do at the peak of exercise, where u inject radionucleotides to see cold spots (areas of ischemia)

A

Myocardial perfusion imaging

29
Q

After what 2 tests do u decide to do a PET scan?

A
  1. EKG. must have baseline abnormality

2. stress test. must be discordant.

30
Q

Which heart chamber can be assessed during by echocardiography during an exercise echo?

A

LV

31
Q

What happens to the LV to give a + exercise echo tests?

A

if regions of LV contractile dysfxn develop with exertion

32
Q

So say your pt can’t exercise (like they broke their legs). What 2 drugs can u give to induce cardiac stress to test for angina?

A

inotropines (like dobutamine) or vasodilators

33
Q

This test is the most direct way to look at the coronary arteries and is the gold standard to angina Dx.

A

Coronary angiography

34
Q

What is a big limitation to coronary angiography (think anatomy)?

A

it only shows u physical problems, and can’t give u info about pathophysiilogical consequences, composition of plaques, or vulnerability to rupture.

35
Q

CT is very good at viewing what type of change in coronary arteries?

A

calcification (but not much else)

36
Q

Which drug can the pt take to cease the activity of acute angina?

A

Nitroglycerin

37
Q

How can B-blockers help treat recurrent ischemic episodes of angina?

A

reduce myocardial O2 demand by decreasing chrono- and ionotropic events

38
Q

What is the class of drugs to prevent acute cardiac events?

A

anti-platelet therapies

39
Q

This is the procedure where they insert a balloon into the artery and inflate it to dilate the stenotic portion of the coronary artery.

A

PTCA (percutaneous transluminal coronary angioplasty)

40
Q

What can be placed during a PCTA to prevent re-stenosis?

A

Stent

41
Q

What can they coat the outside of the stent with to give a little antiproliferative properties to the opened artery?

A

drugs (sirolium, everoliums, paclitaxel)

42
Q

What is the most common vessel to be used in a CABG surgery?

A

Saphenous v.

Cardiovascular 2 (6 decks)

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