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year 3 exam 1 > coronary heart disease > Flashcards

coronary heart disease Flashcards

1
Q

what are the two types of thromboembolic diseases

A

arterial thrombosis
venous thrombosis

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2
Q

what is arterial thrombosis and what can it cause

A

MI, TIA
rupture of atherosclerotic plaque causing vessel occlusion
white thrombi

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3
Q

what is venous thrombosis and what can it cause

A

DVT, PE
can happen in any vessels, red thrombi
usually in deep vein of leg

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4
Q

what is coronary heart disease

A

when the vasculature of the heart is impeded by atheroma, thrombosis or spasm, causes decreased blood flow and ischaemia

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5
Q

what diseases come under CHD

A

ACS -MI, unstable angina
stable angina

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6
Q

what is the epidemiology of CHD

A

4% of UK have symptoms
more common in males until the menopause
124000 acute MI/year

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7
Q

aetiology of CHD

A

atherosclerosis and clot rupture

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8
Q

what are the main risk factors for CHD

A

age
gender
family history
smoking
HT/HL
obesity

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9
Q

what are some other risk factors for CHD

A

diabetes
ethnicity
alcohol
stress

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10
Q

pathophysiology of CHD

A
  • Imbalance between oxygen demand and supply
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11
Q

what is stable angina

A

narrowing of coronary arteries due to atheromatous plaque, results in chest pain provoked by stress/exercise/heavy meals

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12
Q

what are symptoms of stable angina

A

central crushing chest pain, may radiate to jaw, neck, back, arms
no ECG/cardiac enzyme changes

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13
Q

what is the management for stable angina

A

GTN for symptoms control
antianginal
1. beta blocker / CCB
2. long acting nitrate, ivabradine, ranolazine, nicorandil

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14
Q

secondary prevention for stable angina

A

lifestyle advice
antiplatelet
atorvastatin 80mg

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15
Q

what is ACS - MI

A
  • Thrombosis forms at site of rupture of atheromatous plaque
  • Severe and prolonged ischaemia
  • Death of cardiac muscles and enzyme release from cells
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16
Q

what is the difference between NSTEMI and STEMI

A

STEMI - damage to full thickness of cardiac muscle
NSTEMI - damage to partial thickness of muscle

17
Q

symptoms of MI

A
  • ST elevation in STEMI
  • T wave inversion/Q wave changes in NSTEMI
  • increased troponin
  • severe chest pain
  • sweating, breathlessness, N&V, restlessness
18
Q

immediate management for STEMI

A

oxygen
diamorphine and antiemetic
aspirin 300mg stat
clopidogrel 300/ticagrelor 180/prasugrel 60 STAT
PPCI
(if C/I thrombolysis <1hr)

19
Q

what other cardiac enzymes can be tested for when testing for MI/unstable angina

A

creatine kinase - CK-MB cardiac specific
aspartate transaminase - non specific

20
Q

C/I for thrombolysis

A

recent surgery
peptic ulcer
uncontrolled HT
<6hr since start

21
Q

thrombolysis side effects

A

haemorrhage
allergies
arrythmias
stroke

22
Q

secondary prevention of a STEMI

A

dual antiplatelet - 12 m aspirin for life
beta blocker - 12m + if HF
ACEi
atorvastatin 80mg
lifestyle

23
Q

symptoms of unstable angina

A

sudden deterioration of angina symptoms
not relieved by rest or GTN
STEMI ruled out

24
Q

immediate management of STEMI/unstable angina

A

oxygen
diamorphine plus antiemetic
aspirin 300mg stat
clopidogrel 300/ticagrelor 180/prasugrel 60 STAT
fondaparinux until stable
NO PPCI

25
Q

secondary unstable angina/STEMI management

A

6 month CVD risk prediction using GRACE - if >3% - angio and PCI
dual antiplatelet - 12 m aspirin for life
beta blocker - 12m + if HF
ACEi
atorvastatin 80mg
lifestyle

26
Q

what is an angiography

A

○ Thin catheter introduced to coronary circulation
○ x-ray contrast material to allow observation of coronary stenosis

27
Q

what is PCI - percutaneous coronary intervention

A
  1. angioplasty - balloon inserted and inflated at obstruction
  2. stenting - wire mesh inserted to keep stenosis open
28
Q

what are the two types of stent that can be used in PCI

A

bare metal - overtime will become overgrown by endothelium - stenosis
drug eluting - anti-proliferative drug - tacrolimus to stop overgrowth

29
Q

what is a primary PCI (PPCI)

A

PCI but with clot removal - gold standard STEMI treatment

year 3 exam 1 (44 decks)

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