CAD

Question 1

Define CAD

Answer 1

Narrowing or blockage of coronary arteries

Question 2

Risk factors for CAD unique to women

Answer 2

• Smaller coronaries, less developed collateral circulation
• Elevated inflamm state with loss of estrogen
• Lower baseline HDL
• Vague symptoms are normal

Question 3

What is the main component in athero plaques?

Answer 3

LDL

Question 4

How does DM contribute to CAD development?

Answer 4

Lowers HDL

Raises TGs and LDL

Question 5

What is the most important diagnostic tool in CAD?

Answer 5

History

Question 6

Medical management of CAD?

Answer 6

• BP, DM control, lifestyle changes
• Platelet inhibition
• NTG

Question 7

Treatment of STEMI

Answer 7

• PCI (time is muscle!)
• Oxygen
• ASA 325 mg chewed
• NTG sublingual
• Morphine
• Heparin
• B blocker

Question 8

Difference between STEMI and NSTEMI?

Answer 8

• STEMI = full thickness infarct

- NSTEMI = partial thickness infarct

Question 9

What is prinzmetal angina?

Answer 9

• Coronary artery spasm
• Generally in clean coronaries in younger women
• Occurs in early AM

Question 10

What causes prinzmetal angina?

Answer 10

Cold, stress, cocaine, smoking, vasoconstricting meds

Question 11

What are complications of MI?

Answer 11

1. Cardiogenic shock
2. Heart failure
3. Dressler’s syndrome
4. Arrhythmias

Question 12

What is cardiogenic shock?

Answer 12

• Large LV infarct leads to significant decrease in contractility
• Results in very low BP with inadequate supply of oxygen rich blood to body

Question 13

What is Dressler’s syndrome?

Answer 13

• Fever, pleuritis, pericarditis

- Caused by autoimmune reaction to damaged heart muscle, can occur weeks or months after MI

Question 14

Why are ACEI/ARBs used post-MI?

Answer 14

Shown to minimize LV dilation post-MI resulting in lower rates of HF and improved survival