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Cardio Week 4 > CARD 46- Clinical Presentation and Evaluation of Ischemic Heart Disease > Flashcards

CARD 46- Clinical Presentation and Evaluation of Ischemic Heart Disease Flashcards

1
Q

What is Percutaneous Coronary Intervention (PCI)?

A
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2
Q

Describe the Treatment of Stable Angina

A
  • Treatment of aggravating symptoms
  • Adaption of activity
  • Treatment of risk factors
  • Beta-Blockers
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3
Q

Describe the ECG progression in STEMI

A
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4
Q

Describe the common PTs who have Silent Ischemia/Asymptomatic Ischemia

A

More common in women later decades
More common in diabetics

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5
Q

Describe the Physical Exam for IHD

A
  • BP and Pulse
  • New Murmurs
  • Aortic Stenosis can be associated with angina and syncope
  • Carotid bruit
  • S4 can be associated with IHD (nonspecific)
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6
Q

What are the differences in NSTEMI vs STEMI

A
  • EKG ST elevation (STEMI)
  • Enzymes elevated
  • Occasional develop Q wave
  • Tx antiplatelet, heparin, admission (NSTEMI)
  • Tx Reperfusion (STEMI)
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7
Q

How do CCBs relate to Stable Angina?

A

Second line if Beta-Blockers are not tolerated

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8
Q

How do NSAIDs relate to Stable Angina?

A

Small but finite increased risk of myocardial infarction and mortality

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9
Q

Describe the Exercise Stress Test

A
  • Reach 85% of max HR
  • 12 ECG and BP monitoring
  • ST depression 2mm
  • Ventricular Tachyarrhythmia
  • Limitations: abnormal ECG baseline, cannot exercise
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10
Q

Describe an Inferior STEMI

A
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11
Q

Relate Unstable Angina and NSTEMI

A

EKG may show ST depression
Angiogram - partial obstruction
ENZYMES ELEVATED - only NSTEMI

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12
Q

What are the Ischemic Heart Disease Risk Factors?

A
  • FmHx premature CAD 1st degree relative
  • male < 55 female < 65
  • Tobacco products
  • Diabetics 2-4 times the risk
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13
Q

What is Acute Coronary Syndrome (ACS)?

A
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14
Q

What are the Tests for IHD?

A
  • Exercise Stress Test
  • Stress Echo
  • Stress Radionuclide Myocardial Perfusion Scan
  • CT for Calcium scoring
  • Angiography (CT or Coronary)
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15
Q

What are the Anginal Equivalents and what is Atypical Presentation?

A
  • Indigestion
  • Nausea
  • SOB
  • Diaphoresis
  • Dizziness
  • Syncope
  • Fatigue
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16
Q

Describe a Lateral Wall MI

A
17
Q

Describe an Angiography

A

Visualizing vessel lumen

Contrast agent with XR, CT or MRI

18
Q

Describe Unstable Angina

A
  • increased intensity or frequency, does not go away with demand reduction, or occurs at rest
  • ST depression or Normal ECG
19
Q

Describe the relationship between Women and Heart Disease

A
  • More likely atypical presentation
  • 5-10 years older at time of presentation
  • Higher incidence of vasospastic heart disease
  • Less likely to undergo procedures
20
Q

Describe what a Coronary Angiography is

A
  • Catheter placed in arterial circulation and advanced to coronary arteries both right and left
  • Injection of contrast
  • Measure EF (ventriculogram)
  • 70% obstruction considered significant
21
Q

What is Revascularization?

A

CABG and PCI (percutaneous coronary intervention)

22
Q

What is a Stress Radionuclide Myocardial Perfusion Scan?

A

Compares Rest and Exercise images

Inability to dilate shows less uptake of radioactive tracer

23
Q

What is a Stress Echocardiogram?

A
  • Ischemia presents as wall motion abnormality (US)
  • Dobutamine and Adenosine for pt who cannot exercise
24
Q

Describe the relationship between Antiplatelets and Stable Angina

A
  • Aspirin
  • P2Y12 Inhibitors (ADP receptor antagonists)
  • Clopidogrel
25
Q

Describe an Anterior STEMI

A
26
Q

Describe the relationship between Nitrates and Stable Angina

A
  • Systemic venodilation
  • Dilation of coronary vessels and collateral
  • Short acting - NTG spray/tablets
  • Long acting - Transdermal paste/patches
  • Tablets - isosorbide dinitrate
27
Q

Describe what a Coronary Artery Bypass Graft (CABG) is

A
  • Bypass portion of artery with segment of donor artery or vein
  • Left internal mammary artery is preferred over saphenous vein
  • Artery > Vein
28
Q

How do you dx an MI?

A

Cardio Week 4 (8 decks)

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