Coronary Heart Disease Flashcards
What is atherosclerosis?
lipid deposition, calcification, plaque formation in vessels
If you have atherosclerosis in the coronaries what do you get?
ischemic heart disease
Atherosclerosis in the brain causes?
stroke
Atherosclerosis in the mesentary causes?
mesenteric infarction
Atherosclerosis in the lower extremities causes?
claudication, PVD
What are the 7 Framingham risk factors?
male gender, increased age, diabetes, smoking, family hx of atherosclerosis, HTN, hyperlipidemia/hyperchloresterolemia
What are some other diseases that are independent risk factors for atherosclerosis?
lupus, RA, HIV, chronic kidney disease
What does metabolic syndrome consist of?
at least 3 of the following: abdominal obesity, traiglycerides over 150, HDL less than 40 in men and 50 in women, fasting glucose over 110, hypertension
What are signs and symptoms of angina?
chest pain, dyspnea, nausea/vomiting, diaphoresis
What characterizes stable angina?
symptoms relieved with rest or SL nitroglycerin
What is the treatment for stable angina?
exercise, weight control, low fat/low cholesterol diet, nitrates/BB/CCB except nifedipine because it causes reflex tachycardia
What classifies unstable angina?
new onset anginal symptoms, increased intensity of stable angina, increased frequency of angina
What is the mechanism for acute unstable angina?
ruptured coronary plaque leading to bleeding, platelet aggregation and thrombus formation
What does complete occlusion of a coronary vessel cause?
acute MI
Which populations are at a higher risk for atypical presentations of MI?
women, elderly, diabetics–may not have pain, just dyspnea, diaphoresis, nausea, weakness, syncope, ect.
What are the two types of post MI pericarditis?
post-MI pericarditis w/ friction rub (after 24 hours) and Dressler’s syndrome (autoimmune form) 1-2 months later
What do leads V1 and V2 correlate to?
septal or posterior wall
What do leads V3 and V4 correlate to?
anterior wall
What do leads V5, V6, 1 and aVL correlate to?
lateral wall
What do leads 2, 3, and aVF correlate to?
inferior wall
What does a posterior MI look like on EKG?
ST depression, tall Rs and upright T in leads V1 and V2
What should a new LBBB with concerning symptoms be treated as?
STEMI
What are 3 main biomarkers that can be ordered when concerned about MI?
myoglobin, CPK-MB, troponin
When do cardiac biomarkers rise?
only with infarction, not ischemia
What is the gold standard test for acute coronary syndrome and occlusive disease?
coronary angiography
What is the treatment for acute coronary syndrome/ MI?
oxygen, cardiac monitor, nitroglycerin, morphine, aspirin (chew immediately), heparin, beta blockers (oral within 24 hours)
When can patients not get nitroglycerin?
when they are on viagra
Patients with STEMI or new LBBB should be treated with what?
percutaneous coronary intervention (PCI-stenting or baloon angioplasty) or fibrinolytics
When is fibrinolytics preferred over PCI?
when you can’t get the patient to the cath lab before 90 minutes
