Chronic ischemic heart disease

Question 1

characteristics of unstable plaques

Answer 1

few smc's
thin fibrous cap
lots of inflammatory cells
eroded endothelium
activated macrophages

Question 2

steps in development of atherosclerosis

Answer 2

endothelial injury (eg oxidized LDL, infection, smoking, htn)
monocyte migration, cytokine fomation, foam cell formation, smooth muscle proliferation, plaque formation
cap rupture, thrombus formation

Question 3

explain the effect of systolic pressure and volume on oxygen demand

Answer 3

they increase it by increasing ventricular wall tension

Question 4

list progressive symptoms of ischemia

Answer 4

diastolic disfxn, systolic dysfxn, st alteration, angina

Question 5

list some risk factors for atherothrombosis

Answer 5

diabetes, males, age,

Question 6

types of angina

Answer 6

chronic (aka stable, exertional), atypical, anginal equivalents and silent ischemia

Question 7

atypical angina or anginal equivalents

Answer 7

different location, other symptoms of ischemia besides angina like dyspnea, fatigue, nause
mroe common in women and diabetics

Question 8

Canadian Cardiovasc Society Classification

Answer 8

angina class based on degree of limitation of daily activities (1-4)

Question 9

Initial Rx of chronic stable angina

Answer 9

Aspirin and antianginal therapy
Beta-blocker and Blood pressure
Cigarette smoking and Cholesterol
Diet and Diabetes
Education

Question 10

what can a stress MPI tell you

Answer 10

you see radioactive buildup in proportion to blood flow. Tells you ischemic areas

Question 11

what can MPI with SPECT tell you

Answer 11

about the motion of the heart