Cardiovascular Disease Management Flashcards
how does a myocardial infarction happen?
- blood clot
- stops blood flowing to the heat muscle
- depriving heart muscle of o2
how does a clot form?
-if there are plaques
where are plaques formed?
-lining of the arteries
what is the name of the cardiac enzyme that diagnoses myocardial infarction?
-troponin
why do troponin levels increase?
- increase when cells are damaged
- due to oxygen deprivation
how long is the troponin detectable in the serum?
-6 hours after heart attack
how long does troponin remain in the serum?
14 Hours
when does troponin peak?
12-24 hours
what are the 3 names of the plaques causing a heart attack?
- unstable plaque
- stable plaque
- osclerotic plaque
name the 3 different anti platelets
- Ticagrelor
- cangrelor
- prasugrel
What are the 3 main points for unstable angina?
- symptoms of MI
- no rise in troponin
- no change in ECG - therefore stable angina
what is stable angina like?
- chest pain and discomfort
- narrowing of coronary arteries
what are anti-coagulant drugs?
-drugs that prevent blood clotting
what are antithrombotic drugs?
-prevents formation of thrombus
what are thrombolytic drugs?
-drugs that dissolve blood clots
what to anticoagulants target
-coagulation cascade
what happens when the anticoagulants target the coagulation cascade?
-reduce thrombotic and vibrant generation and so thrombotic stability is affected.
do anticoags target thrombosis as well, and if so how?
- yes
- target fibrin clot
what do anti-platelets target?
-haemostatic plug
how does anti-coag target fibrin clot?
- reduces fibrin activity
- therefore destroys the clot
- it is not stable enough so it can’t solidify
Is the arterial system high or low shear rate?
-high shear rate
are the platelets important in arterial system?
- yes - critical role
- rich in platelets - thrombo therefore white
what are some anitplatelet drugs?
-aspirin and CLOPIDOGREL
is the venous system a high or low shear rate?
-low shear rate
what is the venous system rich in?
-fibrin
therefore anticoags used to treat venous thrombosis
do anitplatelet treat venous or arterial thrombosis
-arterial
do anticoags treat venous or arterial thrombosis
-venous
name some anticoagulants?
-warfarin and heparin
what are the 3 factors that contribute to thrombosis?
- Virchow’s triad
1. hyper coagulation
2. endothelial injury
3. disturbance in blood flow
what is the shear like in venous thrombosis?
turbulent shear
what happens in venous thrombosis?
-activation of coagulation cascade and red thrombus formation
what are the 4 anti-coag drugs?
- target co-factors
- target vit k factors
- direct thrombin factors
- factor xa inhibitors
what is the function of antithrombin3
- binds to thrombin
- forms complex
- inactivates thrombin activation
how does heparin help in inducing the inactivation of thrombin?
- binds to antithrombin
- therefore improves its capacity of anti to bind to thrombin and inhibits thrombin
in which category of anti-co drugs does heparin belong to?
-target co factors
in which category of anti-co drugs does warfarin belong to?
-target vit k factors
what does warfarin do?
- inhibits vit k reductase
- vit k reductase enables vit k decedent carboxylation
