CAD, angina Flashcards
worst vessel to get occluded?
left main, turns into LAD (widowmaker)
working cells remain viable for up to
20 minutes
stable angina
Chronic obstruction
Chest pain with exertion
May radiate, may have diaphoresis, SOB, pallor
Relief with rest or nitrates
prinzmetal angina
spasms that come and go
unstable angina
essentially an MI
ASA, ACE, Statin
gold standard for a STEMI
EKG
what are some drugs for stable angina?
- nitrates (don’t take w/PDE 5 I)
- B blockers
- CCB
- statins
chronotropic vs
inotropic
rate
contraction
Temporary loss of contractility that persists for hours to days, this can occur post M/I
myocardial stunning
Chronically ischemic; myocytes are hibernating to preserve function until perfusion can be restored
myocardial hibernation
myocardial remodeling
Loss of contractility mediated by Ang II, catecholamines, and inflammatory cytokines
these things are happening during an MI
- increased O2 demand, epi, renin
- necrosis
- conduction problems
Q waves can indicate
prior MI
classic EKG findings for an MI
T-wave inversion, ST-elevation
prodromal symptoms of an MI
Symptoms usually appear 24-72 hours before
Malaise, Tiredness, Weakness fatigue
Visual disturbance
acute symptoms of an MI
Chest Pain, Dyspnea, Nausea, Diaphoresis, weakness, fatigue, anxiety
Signs: Gray/ashen (from decreased perfusion), gasping, clutching, loss of consciousness, confused, ECG changes, tachycardia, tachypnea
gold standard tx for STEMI
cath lab
most chest pain/MI you would give
Morphine
O2
Nitro
ASA
best lab test for MI
troponins, very heart specific
when would you give fibrinolytics
If you cant get to a cath lab before 2 hours then give fibrinolytics
MCC deathi within 72 hours of MI
cardiac arryhthmias
PTT
heparin
intrinsic
PT/INR
warfarin
extrinsic
new chol goals?
decrease LDL 50% in those with 10 year CAD
statins
rhabdo
niacin
raises HDL best
PSK 9 inhibitors
- familial hyperlipidemia
- repatha
