Clinical: 7 Ischemic HD Flashcards
What is Percutaneous Coronary Intervention (PCI)?
Describe the Treatment of Stable Angina
- Treatment of aggravating symptoms
- Adaption of activity
- Treatment of risk factors
- Beta-Blockers
Describe the ECG progression in STEMI
Describe the common PTs who have Silent Ischemia/Asymptomatic Ischemia
More common in women later decades
More common in diabetics
Describe the Physical Exam for IHD
- BP and Pulse
- New Murmurs
- Aortic Stenosis can be associated with angina and syncope
- Carotid bruit
- S4 can be associated with IHD (nonspecific)
What are the differences in NSTEMI vs STEMI
- EKG ST elevation (STEMI)
- Enzymes elevated
- Occasional develop Q wave
- Tx antiplatelet, heparin, admission (NSTEMI)
- Tx Reperfusion (STEMI)
How do CCBs relate to Stable Angina?
Second line if Beta-Blockers are not tolerated
How do NSAIDs relate to Stable Angina?
Small but finite increased risk of myocardial infarction and mortality
Describe the Exercise Stress Test
- Reach 85% of max HR
- 12 ECG and BP monitoring
- ST depression 2mm
- Ventricular Tachyarrhythmia
- Limitations: abnormal ECG baseline, cannot exercise
Describe an Inferior STEMI
Relate Unstable Angina and NSTEMI
EKG may show ST depression
Angiogram - partial obstruction
ENZYMES ELEVATED - only NSTEMI
What are the Ischemic Heart Disease Risk Factors?
- FmHx premature CAD 1st degree relative
- male < 55 female < 65
- Tobacco products
- Diabetics 2-4 times the risk
What is Acute Coronary Syndrome (ACS)?
What are the Tests for IHD?
- Exercise Stress Test
- Stress Echo
- Stress Radionuclide Myocardial Perfusion Scan
- CT for Calcium scoring
- Angiography (CT or Coronary)
What are the Anginal Equivalents and what is Atypical Presentation?
- Indigestion
- Nausea
- SOB
- Diaphoresis
- Dizziness
- Syncope
- Fatigue