Coronary Artery Disease Flashcards

1
Q

What is the def of CAD?

A

ischaemic heart disease is characterised by the inability to provide adequate blood supply to the myocardium and is primarily caused by atherscelerosis of the epicaridal cornoary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the aetiology of CAD?

A

mostly atherosclerosis

also caused by vasospasm, endothelial and microvascular dysfunction, spontaneous thrombosis, coronary artery dissection, extrinssic compressionn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Whats is the pathophysiology of CAD?

A

Development of lipid rich plaques in the arterial wall arising from an inflammatory process that leads to alterations in VSMCs, matrix proteins and platelets.

Typically occur at bends in the arteries or branch points and also involves a degree of calcification

cause symptoms when 70-80% stenosed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the S&S of CAD?

A
  • Angina (chest pressure, heaviness or squeezing, can radiate and worse on exertion)
  • Dyspnoea
  • Nausea
  • Dizziness
  • fatigue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of Angina?

A

Stable - induced by effort and relieved by rest

Unstable (crescendo) - increased frequency and severity, occurs at minimal exertion or at rest. Much higher risk of MI

Decubitus angina - precipiated by lying flat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations are done for CAD?

A
  • FBC
  • Glucose
  • lipid panel
  • ECG
  • Echo
  • Exercise stress testing
  • Coronary angiography
  • Cardiac computed tomography angiography (CCTA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What may an ECG show in CAD?

A

signs of ischaemic change or previous MI

This can include ST depression, flat or inverted T waves, Pathological Q waves, fragmented QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain exercise stress testing

A

Bruce protocol of exercise on treadmill or bike with ECG monitoring. ECG can show LBBB, ventricular pacing or ST depression

Duke treadmill score can be used to analyse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the treatment options for CAD?

A
  • Risk factor mod i.e smoking cessation, exercise and weight loss. Control HTN and DM. Patient education
  • Anti-platelet e.g aspirin 75mg or clopidogrel 75mg
  • Lipid lowering therapy e.g atorvastatin 10mg or simvastatin 20mg
  • Anti-HTN therapy e.g B-blocker or ACEi
  • Revascularisation i.e CABG or PCI
  • Anti-anginal e.g GTN sublingual spray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the complications of CAD?

A

MI

Stroke

Sudden cardiac death secondary to arrhythmia

Ischaemic cardiomyopathy

HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the classification of angina?

A

Grade 1 = angina on strenous/prolonged ex

Grade 2 = slight limitation of ordinary activity

Grade 3 = marked limitation on ordinary activity

Grade 4 = inability to perform any activity. angina at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly