CCS SIHD 2014 Flashcards
What are the three populations that require further investigations?
1) > 30 y.o with 2 or 3/3 angina criteria
2) Men > 40 or Women > 60 with 1/3 criteria
3) Men < 40 or Women < 60 with 1/3 criteria if other CV risk factors present
Name all 9 modifiable risk factors and 4 non modifiable risk factors?
What are the reasons that an EST is uninterpretable?
ST Depression > 1mm
WPW
LBBB
Ventricular Paced Rhythm
Digoxin effect
Review the Test characteristics of EST, MIBI, CCTA, DSE
What is timeline for symptom onset to NIV testing? Specialist assessment? Cath? Timeline for uptitration of medical therapy?
-2 weeks
-6 weeks
-Another 6 weeks
-12 to 16 weeks
What are the three specific populations with SIHD that should be on ACEi?
-Diabetes
-HTN
-LVEF < 40%
-CKD
What is target for Beta Blockade?
-HR 55-60 bpm
What labs should be ordered in work up?
-Lipids
-HbA1c
-CBC
-Renal Function
-Resting ECG
What are 4 high risk stress test criteria?
- > 2mm ST segment depression at low (< 5 mets workload or persisting into recovery)
-ST Elevation
-VT/VF
-Failure to increase SBP > 120mmhg or sustained decrease > 10mmhg during exercise.
What are 6 high risk criteria for SPECT?
-Resting LVEF < 35% not explained by non coronary cause
-Perfusion deficits > 10% at rest with no previous history of infarct
-Severe stress induced LV dysfunction < 45% or decrease in LVEF (with stress > 10%)
-Stress induced perfusion > 10% involving multiple vascular territories
-TID
-Increased lung uptake
What are 2 high risk criteria for DSE?
- > 2 segments
- WMA with low dose dobutamine (< 10 mcg/kg/min) or at a low heart rate (< 120 bpm)
How is demand factors stratified? (2 x 2)
-Cardiac vs. Non Cardiac
-Decreased Oxygen Vs. Increased Demand
Review Pre test probability
Which patients with SIHD should have coronary angiography? (4)
-High risk features on NIV
-SIHD with high pre test likelihood on CAD
-Ventricular arrhythmias
-Sudden Cardiac arrest
