CAD and Aneurysm's

Question 1

What is the process of Atherosclerosis?

Answer 1

• Foam cells stick cholesterol to artery walls
• Fatty streak formed
• Intermediate lesion formed
• Atheroma formed
• Fibrous plaque formed
• Complicated lesion or rupture occurs

Question 2

List and describe the two types of lesions

Answer 2

Stenotic lesion: few, fibrotic, thick cap, less compensatory enlargement, presents with symptoms of angina and shortness of breath during exercise

Non-stenotic lesion: many, lipid-rich, thin cap, compensatory enlargement, presents with minimal symptoms until ruptured

Question 3

List and describe the two types of angina

Answer 3

Stable angina: chest pain, predicted onset, usually lasts 5 minutes or less, relieved by rest or medication

Unstable angina: chest pain, unpredicted onset, lasts 30 minutes or longer, may get worse, signal of a heart attack will happen

Question 4

List and describe the four classifications of Angina

Answer 4

• Class I – No limitations with PA, Ordinary PA does not cause undue fatigue, dyspnoea, or angina
• Class II – slight limitation of PA, comfortable at rest, ordinary PA results in fatigue, palpitation, dyspnoea, or angina pain
• Class III – marked limitation of PA, comfortable at rest, less than ordinary PA results in fatigue, palpitation, dyspnoea, and angina pain
• Class IV – Inability to carry on any PA without discomfort, symptoms may be present even at rest, discomfort increased with PA

Question 5

What is an aneurysm?

Answer 5

An abnormal swelling or bulge in the blood vessel wall

Question 6

True or false, patients with CAD usually don’t have an aneurysm

Answer 6

False! There is a strong association between CAD and atherosclerosis and aneurysm’s

Question 7

What are treatments options for Aneurysm’s?

Answer 7

Anticoagulants, stents, surgery

Question 8

What are symptoms of an aneurysm?

Answer 8

Many present with no symptoms until burst, however they can present with angina like symptoms

Question 9

What is used to determine if you have an aneurysm?

Answer 9

An echocardiogram

Question 10

What cardiopulmonary test is performed on patients with CAD and why?

Answer 10

A maximal exercise test conducted on a treadmill or cycle ergometer. It provides an intensity threshold 10-15bpm below ischemia

Question 11

Why is a 6MWT or a stage exercise test not deemed valid for this population?

Answer 11

The 6MWT does not provide an ischemic threshold and a stage exercise test may jump too high and miss out on when the ischemia occured

Question 12

What is the emergency procedure of someone have an angina attack during exerise?

Answer 12

• Sit or lie patient down
• Keep calm and call 000 if no history of angina
• Advise patient to take 1 puff of their nitro-glycerine spray or place tablet under tongue and do not swallow it
• Wait 5 minutes and if it doesn’t work, repeat
• Wait 5 minutes and if it doesn’t work, repeat
• If still no relief, call 000

Question 13

What are the three main types of aneurysm’s and which is the most severe.

Answer 13

Cerebral aneurysm, abdominal aneurysm, thoracic aneurysm. Cerebral considered the worst as it has the least survival rate

Question 14

True or false, exercise is safe for patients with aneurysm’s 3-5cm big

Answer 14

True! There is no evidence maximal exercise rupture aneurysm’s this size - they actually increase hemodynamic flow

Question 15

True or false, patients with an an abdominal aneurysm can engage in resistance training but those with a cerebral aneurysm should not

Answer 15

True! Moderate resistance training with BP <200mmHg

Question 16

What are symptoms of an aneurysm rupture?

Answer 16

Signs and symptoms of rupture: severe pain, nausea, low blood pressure, rapid heart rate, light-headedness, confusion