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CAD Flashcards

1
Q

How many chambers are in the heart?

A

4

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2
Q

The circulatory system includes: 5

A
  1. Lungs
  2. Veins
  3. Arteries
  4. Capillaries
  5. The heart
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3
Q

What is the function of the circulatory system?

A

transport oxygen and nutrients to the body’s cells and carry away the waste material of cellular metabolism.

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4
Q

What are the 3 layers of the of heart

A
  1. inner endocardium
  2. middle muscular myocardium
  3. double-layered outer sac, the pericardium
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5
Q

Diastole is

A

Relaxation

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6
Q

Systole is

A

Contraction

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7
Q

Pulmonary circulation

A

Supplies blood to the lungs

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8
Q

What kind of blood is carried via pulmonary circulation and what happens?

A

oxygen depleted blood. C02 is exchanged for O2 and pulmonary vein carries oxygenated blood to the left atria.

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9
Q

Systematic circulation

A

includes coronary circulation and supplies oxygenated blood and nutrients to the body.

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10
Q

Ischemia is

A

a lack of oxygen

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11
Q

Unmodifiable risk factors include (3)

A
  1. age
  2. gender
  3. family history
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12
Q

Modifiable risk factors include (4)

A
  1. hyperlipidemia
  2. Smoking
  3. Hypertension
  4. Diabetes
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13
Q

What is elevated in hyperlipidemia and what is low in hyperlipidemia

A

elevated total cholesterol
elevated LDL
low HDL
and elevated trigs

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14
Q

Increased HDL has a protective value against what

A

CAD

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15
Q

Metabolic syndrome is characterized as having the following (5)

A
  1. Abdominal obesity
  2. elevated trigs
  3. low HDL
  4. Hypertension
  5. Insulin resistance
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16
Q

Aortic sclerosis is

A

the thickening of the aortic valve w/o obstruction

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17
Q

Decreased ankle-brachial index

A

leg BP/arm BP < 1

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18
Q

carotid intimal-media thickness is

A

US assessment of the wall thickness of the inner two layers of the wall of the carotid artery

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19
Q

What are additional risk factors of CAD

A
  1. Metabolic syndrome
  2. Aortic sclerosis
  3. decreased ankle-brachial index
  4. presence of microalbuminuria and/or renal insufficiency
  5. the presence of LVH on EKG or Echo
  6. increased carotid intimal-media thickness
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20
Q

Angina pectoris (cardiac chest pain) is when

A

oxygen demand exceeds oxygen supply

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21
Q

Typical Angina is

A

described as a squeezing or pressure in the middle of the chest (relatively short 1-15 min)

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22
Q

Stable Angina is

A

chest discomfort that occurs predictably and reproducibly at a certain level of exertion and is relieved with rest or nitroglycerin.

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23
Q

Unstable Angina

A

symptoms usually occur more easily or at rest

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24
Q

Dyspnea is

A

shortness of breath (SOB)

25
Q

Ejection fraction is

A

the pumping ability of the heart

26
Q

Congestive heart failure (CHF) is when

A

fluid builds up in the lungs or other body tissues

27
Q

An EKG is a

A

tracing of the electrical activity of the heart, non-invasive test, inexpensive and painless.

28
Q

how many leads are in an EKG

A

12

29
Q

What does an EKG determine

A

any abnormalities of the heart’s rhythm or conduction system

30
Q

Exercise EKG measures

A

the hearts response to exercise

31
Q

Exercise EKG is helpful in the diagnosis and prognosis of what?

A

CAD

32
Q

Abnormal responses during an Exercise EKG include (3)

A
  1. development of angina
  2. extreme change in BP (decrease in BP especially worrisome)
  3. Ventricular premature contractions
33
Q

Exercise capacity is

A

the metabolic equivalent of task

34
Q

how is exercise capacity determined

A

by duration of exercise and protocol used

35
Q

Myocardial perfusion imaging (MPI) improves what

A

specificity and sensitivity of exercise EKG

36
Q

MPI is

A

is more accurate in diagnosis of CAD and better able to assess severity by localizing and quantifying the amount of the myocardium in jeopardy

37
Q

Normal perfusion scan shows

A

the same concentration of tracer throughout the heart

38
Q

A defect is

A

an area devoid of tracer

39
Q

A reversible defect is

A

visualized with exercise but not at rest, generally indicates an area of hypoperfused but viable myocardium

40
Q

A fixed defect is

A

present both at exercise and rest, and indicates a prior myocardial infarction

41
Q

The echocardiogram, the radionuclide angiogram (RNA) - also known as a multi gated acqusition scan (MUGA) and the Gated SPECT allow for what?

A

the assessment of the cardiac chambers

42
Q

Myocardial ischemia is detected as

A

a decrease in LV ejection fraction or the development of a regional wall motion abnormality with exercise

43
Q

Coronary Angiography is the

A

Gold Standard in the diagnosis of CAD

44
Q

Coronary Angiography is and what does it determine

A

an invasive test where the dye is injected directly into the coronary arteries to determine the site, extent and percentage of the coronary obstructiion

45
Q

Intravacular US

A

is able to image atheroma with the vessel wall directly

46
Q

EBCT

A

ultra fast CT scans which are used to detect deposits of calcium in the arterial walls

47
Q

BNP is

A

a hormone produced by the heart in response to stretching of myocardial cells due to volume and/or pressure overload

48
Q

Elevated BNP is associated with

A

higher cardiac and all cause mortality

49
Q

Nitrates cause what and improve what

A

Cause coronary arteries to dilate and improves blood flow and relieves angina

50
Q

How do beta-blockers prevent angina

A

by slowing the HR and decreasing force of contraction which decreases the need for myocardial oxygen

51
Q

Calcium channel blockers

A

some increase blood flow (nifedipine) and some decrease oxygen demand (verapamil)

52
Q

Statins main function is to

A

lower LDL levels

53
Q

Statins can be in the ______ or _______ prevention of _____

A

Primary
Secondary
CAD

54
Q

What is a PTCA

A

Balloon tipped cath inserted into peripheral artery and it is inflated at the site of obstruction, fractures plaques which increases the lumen of the blood vessel

55
Q

CABG is

A

revascularization where a new connection is made from the aorta to the coronary artery by use of a graft. (detour for blood flow)

56
Q

Left ventricular function is

A

the assessment of the hearts ability to pump and adequate amount of blood to meet the bodys metabolic needs

57
Q

LVEF is

A

the % of blood in the ventricle delivered to the body with each heartbeat

58
Q

Best Case CAD risk profiles (10)

A
  1. Onset of CAD at later ages
  2. Stable angina
  3. Normal LV function and EF
  4. Mild, single vessel disease excluding LM
  5. No arrhythmias
  6. No progression of the disease
  7. No diabetes or other chronic disease
  8. well controlled cardiovascular risk factors including the use of a statin and asprin
  9. good exercise capacity
  10. Negative stress test
59
Q

High Risk CAD profile includes (11)

A
  1. Early onset (before 40)
  2. Unstable or worsening of disease
  3. CHF or poor LV function
  4. reduced EF
  5. severe 3-vessel disease or LM disease
  6. Presence of arrhythmias
  7. Significant progression over a short period of time
  8. poorly controlled cardiac risk factors
  9. CHD in the setting of valvular heart disease
  10. poor exercise tolerance
  11. Severe stress testing abnormalities (drop in BP with exercise)

CAD (1 decks)

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