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Arteriosclerosis & Vascular disease > Arteriosclerosis > Flashcards

Arteriosclerosis Flashcards

1
Q

Chest pain: first line Inx

A

12-lead ECG

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2
Q

NSTEMI: Inx after ECG

A

Exercise tolerance ECG

Bloods: Troponin (useful in myocardial damage)

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3
Q

Diagnosis: exercise tolerance test - genuine ST depression

A

Angina

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4
Q

ECG: what does ST depression signify

A

Acidosis in myocardium

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5
Q

Chronic statble angina: definiton

A

Partly blocked coronary artery
When HR rises, ischaemia becomes significant and lactate accumulates

ECG: ST depression (acidosis in myocardium)

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6
Q

Chronic stable angina: Management (4 drugs) and other management

A

Aspirin: prevent platelet aggregation
Beta-blocker (slow HR): atenolol
Nitrates (GTN/ ISMN - PRN) - dilate arteries
Statin (Simvastatin/ atorvastatin)

Angioplasty/ CABG/Angiogram

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7
Q

Acei - For which CVS condition

A

Heart failure

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8
Q

Coronary arteries: supply

A

Left coronary artery: anterior wall/ anterio-lateral wall

Right: inferior wall

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9
Q

Angina: complication

A

If left untreated:

Acute myocardial infarction

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10
Q

ECG finding: acute myocardial infarction

A

ST elevation MI (STEMI)

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11
Q

Cardiogenic shock: which patient

A

When V1-V6 blocked (whole of left ventricle)

Left coronary artery blockage (both branches)

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12
Q

ECG finding: inferior STEMI.

A

Lead II, III & AVF

Right coronary artery

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13
Q

Heart attack (STEMI): management

A

Medical emergency (within 1-2 hours)

Unblock coronary artery: PCI, angioplasty

If not available, thrombolysis with tPA (alteplase or streptokinase)

Until then: aspirin & nitrates, beta-blocker & station (reduce ischaemia during transfer)

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14
Q

Risk factors & Management: CVS

A

Diet & exercise
Stop soking
Reduce BP: low salt, drugs
Lipids: statins

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15
Q

Management guidelines: Hypertension

A

ACE-inhibitor/ angiotensin II
CCB
Thiazide-like diuretic

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16
Q

Hypertension Management: Why is CCB first line for afro-carribean demo.

A

different Renin-angiotension system

Dilator would work best compared to renin blocker

17
Q

Optimal medical therapy: HA

A 
Intensive lifestyle modification
Aspirin
High dose station (atorvastatin 60-80mg)
optimal BP control
Assess T2DM

Aggressive management of BP and lipids improve survival

18
Q

PCSK9 inhibitor: Used for what?

A

Used when statin contraindicated

PCSK9 protein controls LDL receptors
Inhibition of PCSK9 decreases LDL recycling -> lower cholesterol

Evolocumab: monoclonal antibody

19
Q

Evolocumab (PCSK9 inhibitor): conclusion

A

Good relative risk (20%, preventing event) but non-significant improvement for absolute risk eg. death (0.1% in 3 years)

Arteriosclerosis & Vascular disease (1 decks)

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