Coronary Heart Disease Flashcards
what is angina
symptomatic reversible myocardial ischaemia that presents during exertion
what is angina’s pathophysiology
atheroma is present in coronary vessel but blood can still pass through at rest- during exercise however there is a higher demand for blood which small aperture cannot accommodate
aetiology of angina
smoking, HL, HT, atherosclerosis
when is angina provoked
exercise, after a big meal, stress, cold, wind
symptoms of angina
chest pain-squeezing, visceral pain, may radiate to arms/neck/jaw, breathless, burning in stomach
what may angina mimic
reflux
what is the timing of presentation for angina like
short onset, quick relief of symptoms
what are 2 classes of angina
stable & unstable
tx for angina
1y: GTN for symptomatic relief, BBs, long acting nitrate e.g. ivabradine/ nicorandil
2y: aspirin, statin, ACEI
lifestyle: no smoking, diet change
procedure: revascularisation
what 3 emergency cases should be ruled out if acute cardiac presentation comes into A&E
MI
PE
Aortic dissection
what are 2 main revascularisation procedures and roughly describe both
CABG: Coronary artery bypass graft-saphenous vein & internal mammary attached to aorta distal to site of blockage
PCI: percutaneous coronary intervention- radial/femoral access for catheter to root of coronary, balloon threaded over wire to expand artery and then stent implanted
what is 1y PCI
emergency PCI where anti platelets/anticoagulants can’t be given just to patent infarct-related artery in STEMI
True/False…
thrombolysis given if revascularisation not available for MI patient within 3 hrs
False…
within 2 hrs. thrombolysis is administration of clot-dissolving medication
what drug is typically given in thrombolysis
streptokinase - Fibrinolytic
what revascularisation is given for a STEMI
1y PCI / thrombolysis
