Coronary Heart Disease 1 - Atherosclerosis and Stable Angina Flashcards
Define Ischemia
An inadequate blood supply to an organ or part of the body (especially heart muscles)
Define Atherosclerosis
a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls
What is the difference between modifiable and unmodifiable risk factors?
Modifiable - you can change
ex. smoking, weight, diet, cholesterol, blood pressure, stress etc.
Unmodifiable - you can’t change
ex. male, over 40, ethnicity, genetics, etc.
Describe what stable angina is
Angina means that there is poor blood flow through the vessels of the heart. Stable angina means that the discomfort is felt as chest pain or shortness of breath usually during activity or stress. Stable angina pain goes away with rest!
What is an angiogram?
A procedure where dye is injected into the blood, and is shown illuminated as it gets pumped through the heart vessels.
What is oxygen supply? What is it dependent on?
How much blood is travelling through the arteries.
- blood flow
- oxygen content
What is oxygen demand? What is it dependent on?
How much oxygen is needed?
- heart rate
- blood pressure
- contractile force
- ventricular wall tension
Explain the atherosclerosis cascade.
- LDL cholesterol gets into the artery.
- Macrophages swallow cholesterol and make a foam cell.
- Cytokines call for more macrophages (call for a bigger response).
- Smooth muscle enter the inflamed area as well and causes plaque to form onto the artery wall. This impairs blood flow.
- Plaque is formed and attaches to artery wall (fibrous cap flows over the plaque which is very hard to remove).
List 4 causes of ischemia. What is the most common?
- atherosclerosis (most common)
- vasospasm
- emboli (clot from bacteria buildup)
- cogenital malformations (patient’s genetics)
What are signs/symptoms of a stable angina?
- chest pain (due to build up for chemicals - adenosine)
- referred pain - thoracic nerves are attached to the heart nerves and are attached to the head and arm
- nausea/vomitting - vagus nerve
- shortness of breath - dysfunction of systole and diastole
- bradycardia - AV node doesn’t get enough blood
- tachycardia - stress
- shock
What is bradycardia?
low heart rate - less than 60 bpm
What is tachycardia?
high heart rate - more than 100 bpm
List some strategies that could help manage angina.
- controlling comorbid diseases
- quit smoking
- exercise
- weight loss
- drug related therapy
Explain what is happening when a patient who has stable angina is experiencing chest pain
There is a build up of chemicals (specifically adenosine)
Explain what is happening when a patient who has stable angina is experiencing radiating pain
The nerves attached to the heart are continuous with the dorsal thoracic nerves which innervate the arms, face, and neck. That is why the pain from the heart travels through those nerves and to the other target organs which experience radiating pain.
