CAD Flashcards
Name a risk factor for coronary artery disease (excluding age and gender)
- Cigarette smoking
- Dyslipidemia
- Hypertension
- Diabetes
- Abdominal obesity
- FmHx premature MI
- Cocaine use
Describe stable cardiac angina
chest discomfort/dyspnea with exertion, resolved with rest or nitroglycerin
Name a physical exam finding that is associated with coronary artery disease
- Central obesity
- Sweaty
- Short of breath with exertion
- High blood pressure
- Diminished peripheral pulses
- Bruits of arteries
What do pathologic Q waves represent on EKG?
Previous myocardial infarction
Name two indications for a cardiac stress test
- Patients with symptoms suggesting stable angina with intermediate pretest probability of disease
- Pre-operative risk assessment for non-cardiac surgery
- Patients with significant change in cardiac symptoms
- After resolution of acute chest pain
- Prior to angiography to localize lesion
What is the contraindication to cardiac stress testing?
Unstable angina (any acute coronary syndromes)
Which patients should have cardiac imaging with their stress test?
Patient with known coronary artery disease or multiple risk factors for coronary artery disease
What is the typical time duration of chest discomfort associated with ACS?
Lasts >20min but <1hour
What are the classic associated symptoms during ACS?
Shortness of breath, nausea, diaphoresis and lightheadedness
What is the definition of unstable angina (two features)?
- No troponin elevation
2. Unstable plaque
What is the clinical difference between NSTEMI and STEMI?
STEMI involves total coronary artery occlusion, usually more significant myocardial damage, generally worse outcomes
What are the main pathophysiology of myocardial ischemia?
Myocardial oxygen demand is determined by HR Clinical marker of afterload Myocardial was tension Myocardial contractility
Myocardial oxygen supply is determined by
Oxygen carrying capacity of the blood
The degree of oxygen unloading from hemoglobin to the tissues
What is the definition of Acute Coronary Syndrome (ACS)?
a clinical spectrum of acute coronary artery disease that includes
unstable angina
acute MI
sudden coronary death
what are the etiology of ACS?
obstruction of coronary artery blood flow by a thrombus that develops as a result of fissure or erosion of an underlying atherosclerotic plaque
What is the definition of chronic IHD (CAD)?
aka ischemic cardiomyopathy is progressive heart failure
