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ICM > Cardio Session 2 > Flashcards

Cardio Session 2 Flashcards

1
Q

Unstable angina biomarkers?

A

none after initial onset of pain

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2
Q

Unstable angina 3 principal presentations?

A
  1. Rest angina >20 mins
  2. New onset
  3. Increasing pattern of ocurrence
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3
Q

Clinical presentation of NSTEMI?

A

Myocardial damage resulting in release of biomarkers

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4
Q

Clinical presenation of STEMI?

A

Red clots

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5
Q

What % of infarctions are NSTEMI vs. STEMI

A

NSTEMI: 2/3
STEMI: 1/3

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6
Q

Define atherosclerosis

A

Ongoing process of plaque formation in intima of arteries

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7
Q

Stable angina presentation?

A

Deep diffuse chest pain that is brought on by exertion and relieved by rest and nitroglycerin

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8
Q

How does UA differ from SA?

A

More severe, occurs at rest, substernal and radiates to neck, jaw, left shoulder and left arm

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9
Q

Anginal equivalent symptoms include? 5

A
  1. Dyspnea
  2. Nausea
  3. Vomiting
  4. Diaphoresis
  5. fatigue
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10
Q

Most common anginal equivalent?

A

Dyspena

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11
Q

Five most important history related factors to identify ischemia? (5)

A
  1. Nature of symptoms
  2. History of CAD
  3. Male
  4. Old
  5. # of tradiational risk factors
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12
Q

High risk ACS patients have what symptoms? (6)

A
  1. Diaphoresis
  2. Pale cool skin
  3. Sinus tachycardia
  4. S3 or S4
  5. Rales
  6. Hypotension
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13
Q

Typical Angina has what 3 parts?

A
  1. Substernal
  2. Exertion
  3. Relief by rest of nitroglycerin
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14
Q

Atypical angina has what requirements?

A

Two of the typical symptoms

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15
Q

Non-anginal chest discomfort has what requirements?

A

Less than two typical angina symptoms

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16
Q

In terms of quality of chest pain what is predictor?

A

Sharp or stabbing decreased likelihood of MI

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17
Q

3 P’s of precipitating factors of non-MI chest pain

A

Pleuritic
Positional
Palpable chest pain

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18
Q

In terms of exercise, what does it predict?

A

Exertion is associated with MI

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19
Q

Chest pain characteristics that increase likelihood of ACS/AMI?

A

Chest pain that radiates to one shoulder or both shoulders and is precipitated by exertion

20
Q

Chest pain characteristics that decrease likelihood of ACS/AMI?

A

Pain that is stabbing, pleuritic, positiona, or reproducible by palpation

21
Q

High likelihood of ACS is seen in patients that present how?

A

Chest/left arm pain, known history of CAD, murmur, edema, ST segment deviation, Elevated cardiac markers

22
Q

Intermediate likelihood of ACS is seen in patients that present how?

A

Chest/left arm pain as chief symptom, older than 70, male, diabetic, normal ecg and normal cardiac markers

23
Q

Low likelihood of ACS presents how?

A

Symptoms but no risk factors, cocaine use, chest pain from palpation, no ecg change, normal cardiac markers

24
Q

ANgina equivalents are seen in which population the most?

A

Elderly, women, and diabetics

25
Q

stable angina usually lasts how long?

A

2-10 minutes, relieved by rest

26
Q

Common cause of ACS’s?

A

DIsruption of high risk plaques

27
Q

Angiographic evidence of coronary thrombus formation is seen in what % of STEMI patients?

A

90%

28
Q

Key concept in STEMI is?

A

Ventricular remodeling

29
Q

What is infarct expansion?

A

Acute dilation and thinning of area of infarction that is not due to additional necrosis

30
Q

How do sexes differ in STEMI’s?

A

Women present at older age and later onset than men

31
Q

Elderly patients are more or less likely to complain of chest discomfort in STEMI?

A

Less

32
Q

Elderly patients are more or less likely to complain of shortness of breath and other atypical symptoms in STEMI?

A

More

33
Q

How has epidemiology changed in STEMI’s? 2

A

Increase in NSTEMI patients

Decrease in STEMI deaths

34
Q

Five most important factors in ischemia due to CAD?

A
  1. nature of symptoms
  2. prior history of CAD
  3. Male sex
  4. Older age
  5. Number of traditional risk factors present
35
Q

Age difference in sexes for NSTEMI’s?

A

Older than 55 if male

Older than 65 if female

36
Q

Class I angina grade?

A

ANgina with prolonged exertion

37
Q

Class II angina grade?

A

Angina when doing stairs, hills, bad weather, and slightly limits ordinary activity

38
Q

Class III angina grade?

A

1-2 blocks and 1 flight of stairs

39
Q

Class IV angina?

A

No physical activity without discomfort

40
Q

Angina Type I?

A

Atypical chest pain that is not exertional

41
Q

Angina Type II?

A

Stable angina without a change in frequency and is controlled by rest or nitro

42
Q

Angina Type III?

A

UA or MI: Angina >20 mins

43
Q

Strongest arguments for CAD in patient with intermittent chest pain?

A 
Typical angina
Ankle to arm pressure index
Prior MI
Acus senilis
Older than 70
Positive earlob ecrease
44
Q

3 characteristics to be wary of when determining CAD?

A

Earlobe crease, arcus senilis, GI cocktail

45
Q

What predicts the risk of adverse CV outcome?

A

Parenteral history of MI

ICM (4 decks)

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