Chronic Ischemic Heart Disease

Question 1

Why does CIHD affect women later than men?

Answer 1

Women protected by estrogen

Question 2

Risk factors for CIHD?

Answer 2

Age
Family History
Diabetes
Hypertension
Smoking
Cholesterol
Obesity
Sedentary

Question 3

Metabolic syndrome is associated with what?

Answer 3

Associated with inflammation, coagulation abnormalities, progression to type 2 DM

Question 4

Manifestations of coronary artery disease?

Answer 4

Chronic stable angina
Unstable angina
Myocardial infarction
Ischemic cardiomyopathy 
Sudden cardiac death
Silent ischemia

Question 5

What heart sound will show up during an ischemic attack

Answer 5

S4

Question 6

Most important parts of Ischemic heart disease evaluation?

Answer 6

Stress testing

Measure of LV function

Question 7

Where is angina pectoris pain felt?

Answer 7

Diffusely and substernally

Question 8

Atypical angina is characterized how?

Answer 8

Brought on when not exerting

Not received by rest or nitroglycerin

Question 9

Areas not usually associated with myocardial ischemia pain?

Answer 9

Right side
JAw
Epigastrium
Back

Question 10

Class 1 of angina described as?

Answer 10

No angina

Question 11

Class 2 of angina described as?

Answer 11

Angina on more than usual activity

Question 12

Class 3 of angina described as?

Answer 12

Angina on less than usual activity

Question 13

Class 4 of angina described as?

Answer 13

Angina at rest or on any activity

Question 14

Problem with having nocturnal angina?

Answer 14

Body should be at lowest metabolic demand so it may be indicative on a serious problem

Question 15

Pain of pericarditis is what?

Answer 15

Variable duration, sharp, positional, pleuritic, worse with inspiration

Question 16

Pain of aortic dissection?

Answer 16

Excruciating, ripping, sudden, anterior, radiating to the back, unequal pulse

Question 17

Pain of pulmonary embolism?

Answer 17

Sudden onset dyspnea and pleuritic pain

Question 18

Pain of musculoskeletal?

Answer 18

Sudden onset, fleeting, reproduced by palpation

Question 19

Pain of GERD?

Answer 19

Burning, substernal, epigastric 10-60 minutes, related to meals

Question 20

Psychological pain?

Answer 20

Tightness, aching, with dyspnea, non-exertional, lasts more than 30 minutes

Question 21

EKG will bro normal in what percentage of patients with ischemia?

Answer 21

50%

Question 22

Do you do a stress test on asymptomatic people?

Answer 22

No

Question 23

At what percent block do you fix stenosis?

Answer 23

70%

Question 24

Pros of exercise stress ECG?

Answer 24

Low cost
Versatile
Validated
No IV access needed

Question 25

Cons of ECG stress test?

Answer 25

High false positive Unreliable with abnormal resting ECG False negative

Question 26

How big does a horizontal or downslopping ST depression have to be to be diagnostic of ischemia?

Answer 26

Greater than 1mm

Question 27

Abnormal LV occurs at what level of functioning?

Answer 27

Less than 40% ejection fraction

Question 28

At what percent of myocardial ischemia does revascularization therapy become helpful?

Answer 28

11-20%

Question 29

Indications for coronary angiography in stable CAD?

Answer 29

Persistent symptoms despite medical therapy Non-invasive test results suggesting high risk CAD Equivocal or non-diagnostic test results High risk occupation

Question 30

Which leads are indicative of right coronary?

Answer 30

2, 3, and aVF

Question 31

Which leads are indicative of lateral?

Answer 31

1, avL, V4-V6

Question 32

Which leads are indicative of Anterior heart?

Answer 32

V1-V4