Coronary Heart Disease Overview

Question 1

What can lead ot transient ischaemia?

Answer 1

A stable plaque becoming an unstable plaque which causes a slight occlusion. Slide 9

Question 2

What can a chronic closure of a coronary artery cause?

Answer 2

Cause scar formation and there is remodelling of the cardiac tissue causing ischaemic cardiomyopathy. Slide 9

Question 3

What is cardiogenic shock?

Answer 3

Inadequate systemic perfusion as a result of cardiac dysfunction. Slide 14

Question 4

Can angina be proven by tests?

Answer 4

It is a clinical diagnosis, test can only suggest the presence/absence of obstructive coronary lesions. Slide 23

Question 5

What are the key points from a history that suggest angina?

Answer 5

Hard to describe and often have a pressing gesture to their chest.
How it can be releived e.g. stop exercise.
Whether the person has any risk factors. Slide 29

Question 6

What are descriptions of non-related coronary disease?

Answer 6

Dull, stabbing.
Focal.
No patterns, occurs at rest.
Etiher fleetng or prolonged.
No risk factors. Slide 31

Question 7

What are some differential diagnosis of chest pain?

Answer 7

GI: Acid reflux, peptic ulcer
MSK: Injury, tender, nerve root pain.
CV: Pericarditis
Resp: Pleurisy. Slide 32+33

Question 8

If there is someone with acute chest pain, what could the possibilities be?

Answer 8

MI
PE
Aortic dissection. Slide 34

Question 9

Only people with coronary disease can get angina. True or False?

Answer 9

False, it is possible for patients without coronary disease to have angina. Slide 40

Question 10

What are some tests used to see if coronary disease is present?

Answer 10

Exercise test
Perfusion Imagining
CT Angiography
Angiography. Slide 42-47

Question 11

What are some pros and cons for exercise testing?

Answer 11

Cheap, reproducible

Poor diagnostic accuracy in some important sub groups. Slide 42

Question 12

What are some pros and cons of CT angiography?

Answer 12

Non-invasive

Radiation and is less precise than angiography especially when Ca is present. Slide 46

Question 13

What interventions are possible for releiving symptoms of coronary disease?

Answer 13

Drugs
Lifesyle
Revascularisation. Slide 51

Question 14

What are examples of some drugs that can be used for coronary disease?

Answer 14

Aspirin
B blockers
Statin
ACE inhibitor. Slide 52