Coronary Artery Disease

Question 1

What is coronary artery disease

Answer 1

Restriction in blood supply to heart tissue to meet demands

Question 2

When is coronary artery disease symptomatic

Answer 2

> 70% stenosis

Question 3

What is hypoxia

Answer 3

Lack of blood supply to meet demands

Question 4

What are the types of hypoxia

Answer 4

Hypoxic - low inspired O2
Anaemia - low Hb to deliver O2
Stagnant - abnormal delivery
Cytotoxic - abnormal at tissue level

Question 5

What causes coronary artery disease

Answer 5

Coronary artery atheroma

Question 6

What affects O2 supply in blood

Answer 6

Inspired O2
Pulmonary function
Blood constituent
Blood flow

Question 7

What can CAD cause

Answer 7

Stable angina

ACS

Question 8

What are the RF

Answer 8

Age
Male 
Smoking
DM 
Hypercholesterol
Hypertension
FH

Question 9

How do you Dx

Answer 9

Coronary angiography
ETT
Other functional - stress ECHO / cardiac MRI

Question 10

What do you do for typical angina Sx + history of CAD

Answer 10

Treat as stable angina

Non invasive testing if further Dx required - ETT

Question 11

What do you do for atypical angina

Answer 11

CT angiography
Functional imaging 2nd line
Invasive angiography

Question 12

What do you do for non-angina chest pain / cannot exclude angina + ECG changes

Answer 12

Investigate for angina / cardiac chest pain

Question 13

What do you do for non angina chest pain and no ECG change

Answer 13

Explore DDX e.g. non-cardiac

Question 14

What should you do if angina but no Hx of IHD

Answer 14

Look for exacerbating factor
Anaemia
Cardiomyopathy

Question 15

What is the Rx of CAD

Answer 15

Lifestyle
Secondary prevention
PCI
CABG

Question 16

What do you do if Sx <12 hours or current + abnormal ECG

Answer 16

Give aspirin

Refer emergency

Question 17

What do you do if <12-72 hours + abnormal ECG

Answer 17

Refer same day assessment

Question 18

What do you do if >72 hours

Answer 18

Full assessment
ECG
Cardiac enzyme
Decide about referral