Coronary Artery Disease Flashcards
What is he most common underlying cause of CAD, MI, and Heart Failure?
Atherosclerosis
4 top risk factors for atherosclerosis?
High cholesterol, HTN, diabetes, and smoking
3 “other” risk factors for atherosclerosis?
Obesity, family history of heart disease, and physical inactivity
Good definition of metabolic syndrome?
Cluster of conditions that, when occurring together, increase a person risk for heart disease, stroke, and diabetes
What are the 6 conditions under the umbrella of metabolic syndrome?
Insulin resistant, HTN, high cholesterol, high uric acid, hyper coagulable, obese
What is supply and demand angina?
Decreased oxygen delivery to the tissue leading to ischemia. Increased demand leading to ischemia
2 mechanical consequences of ischemia?
Heart failure and myocardial necrosis
3 biochemical consequences of ischemia?
Fatty acids can’t be oxidized, increased lactate, and metabolic acidosis.
3 electrical consequences of ischemia?
T wave inversion, ST segment displacement and electrical irritation like V tach or V fib.
What is the displacement of the ST segment for subendocardial and subepicardial ischemia?
Endo is depression and epi is elevation
LAD occlusion causes what infarction and which leads do we look at for it?
Anterior wall infarction. V1-V7.
RCA occlusion causes what infarction and which leads show it best?
Inferior wall infarction or RV infarction. 2,3,F, V3-V6.
Circumflex artery occlusion causes which infarction and which leads see it?
Lateral wall infarction. 1, L, V5-6.
Posterior descending artery causes what infarction and which leads see it?
Posterior wall infarction. V1-3.
What are CV causes of chest pain?
IHD, Pericarditis, Myocarditis, and cardiomyopathies
6 non cardiac symptoms of IHD?
Dyspnea, sweating, dizziness, syncope, fatigue and weakness.
What is Levine’s sign?
Clinched fist over chest to describe their angina
On physical exam, or just looking at the patient, what are signs that they have risk factors for IHD?
Xanthelasma, xanthomas, diabetic skin lesions, nicotine stains, pale, and absent peripheral pulses.
What 5 things can mimic angina in the absence of CAD?
AS, AI, Pulmonary HTN, hypertrophic cardiomyopathy, and HF
What is acute coronary syndrome?
Unstable angina and non st elevation myocardial infarction because a plaque ruptured or erosion.
What do we mean when we say unstable angina?
New or worsening chest pain lasting over 20 minutes and it’s just there now. Nothing needs to provoke it.
3 things going on with NSTEMI?
Chest pain, elevated cardiac enzymes, and no st elevation
What is so bad about the plaque rupture, how does it lead to ischemia?
The fibrous cap is broken through and everything underneath is thrombogenic. Platelets aggregate and lead to thrombus and occlusion of the artery.
What’s going on with cardiac enzymes in unstable angina?
Normal
In stable angina, what is the most common st displacement?
Depression, so subendocardial injury/ischemia
What are the 5 differential diagnosis for NSTE ACS?
PE, aortic dissection, VHD, myocarditis/pericarditis, stress cardiomyopathy
How quickly can we detect Troponin I levels and CKMB levels in NSTEMI?
TI detected within 2-4 hours
CKMB detected within 3-6 hours
