Coronary Artery Disease Flashcards
What is angina?
What are the two kinds of angina and what differentiates them?
Angina is the reduction of blood flow through a coronary blood vessel reducing perfusion of the myocardium
Stable angina is angina that occurs upon physical exertion
Unstable angina is angina that can occur at rest
What are the risk factors for coronary artery disease?
Modifiable
- Diabetes* (Endothelium damage by increased sugar)
- Smoking (Endothelium damage)
- Dyslipidaemia (Lipoprotein deposition)
- Obesity (Increased cardiac effort)
- Sedentary Lifestyle
- Hypertension (Endothelial damage)
Non-modifiable
- Age
- Sex (Testosterone driven individuals at higher risk)
- Family history
- Ethnicity
- Diabetes*
What is atherosclerosis?
Atherosclerosis is the thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery
What is a popular vasodilating spray used to relieve stable angina symptoms?
Glycerol Trinitrate lingual spray (GTN spray)
What is Acute Coronary Syndrome (ACS)?
What are some symptoms of ACS?
An umbrella term encompassing Stable and unstable angina and myocardial infarction
Symptoms can include
- Pain (Not always present)
- Fatigue/Weakness
- Nausea
- Insomnia
- Shortness of breath
- Confusion
- Collapse
- Anxiety
- Sense of impending doom
What is a myocardial infarction?
Sustained ischaemia leading to irreversible myocardial necrosis
What are two kinds of myocardial infarction, and what causes both?
Non-ST-elevation myocardial infarction (NSTEMI) is caused by partial coronary vessel occlusion. This might not cause ECG changes
ST-elevation myocardial infarction (STEMI) is caused by total coronary vessel occlusion. This causes ECG changes
What is collateral circulation?
The formation of bypassing arteries around an occlusion to maintain perfusion
What will differentiate the presence of Non-ST-Elevation Myocardial Infarction (NSTEMI) from unstable angina?
A troponin 1 test to detect myocardial damage.
Troponin 1 will be present in an NSTEMI but not in unstable angina
What are some diagnostic tests for Acute Coronary Syndrome/Myocardial infarctions?
ECG/EKG
Cardiac enzyme tests (Troponin)
Angiogram
What is the normal range for Troponin T?
less than 15 ng/L
What are common surgical interventions for ST-Elevation Myocardial Infarctions?
Rescue angioplasty (Stenting), pushing and squishing atherosclerotic plaque aside
Coronary artery bypass grafting
What is the management strategy for a Non-ST-Elevation Myocardial infarction?
Optimise myocardial oxygen supply
- Anti-platelets (Prevent thrombus formation acutely and in the long term)
- Beta-blockers (Slows heart rate to decrease blood pressure)
- Ace inhibitors (Prevention of heart remodelling & hypertrophy)
Close monitoring
