Cardiology: Coronary Artery Disease CAD Flashcards
what condition is risk equivalent to CAD?
DM, symptomatic CAD, peripheral arterial disease, and abdominal aortic aneurysm (AAA)
name the clinical manifestations of CAD?
stable and unstable angina, SOB, dyspnea on exertion, arrhythmias, MI, heart failure, and sudden death
name some risk factors of CAD?
family history of premature CAD (males,55, females45, females >55), and male gender.
how is angina pectoris defined?
substernal chest pain secondary to myocardial ischemia (O2 supply and demand mismatch)
how does prinzmental’s variant angina mimic angina pectoris?
it’s the same pain but caused by vasospasm of coronary vessels
what pt does prinzmental’s variant angina affect? when? what ECG and cardiac enzyme levels are associated with it?
young women at rest in early morning
associated with ST-segment elevation in absences of cardiac enzyme elevation
what is the classic triad of angina pectoris?
substernal chest pain that precipitated by stress and relieved by rest or nitrates
describe pain of angina pectoris? what other symptoms is it associated?
pain can radiate and may be associated with SOB, nausea/vomiting, diaphoresis, or lightheadedness
what is found on PE of pts with angina pectoris?
generally unremarkable PE, can have carotid and peripheral bruits
what other things should be ruled out?
pulmonary , GI or other cardiac causes of pain
what is seen on ECG of pts with CAD?
significant ST segment changes on exercise stress test with ECG monitoring
Who may have clinically silent MIs?
women, diabetics, elderly, and post-heart transplant pts
how are symptoms of acute CAD treated?
ASA, O2, IV nitroglycerin, and IV morphine. consider IV beta blockers
also nondihydropyridine CCBs (diltazem, verapamil) and ACEIs has also been validated
what should be ruled out in pt with acute CAD?
acute MI. admit pt to hospital until this has been ruled out
treat chronic symptoms of CAD with what? first line? second line?
first- nitrates, ASA, beta-blockers
sedondary=CCBs
