Coronary Heart Disease Overview Flashcards
Sudden death and CHD?
50% of deaths are sudden
2/3 of these being 1st manifestation / low risk
Development of cardiac arrest?
- Stable plaque->unstable plaque->Transient ischemia=CA
- Acute occlusion-> Acute MI=CA
- Chronic closure->scar formation =CA or Ischemic Cardiomyopathy = CA
Modifiable factors for having cardiac arrest?
Genetic profile Drugs/electrolytes Ischemic burden Hemodynamic fluctuations Autonomic variations
What is cardiogenic shock?
Inadequate system perfusion as a result of cardiac dysfunction
What can cause cardiogenic shock?
Acute MI-multivessel disease percluded LAD
Mechanical complications
How do you diagnose angina?
It is a clinical diagnosis- can be confirmed by history, examination not tests
Clinical diagnosis of angina?
- Visceral pain from myocardial hypoxia - hard to describe, Gestures
- Characteristic patterns of Provocation-exertion,cold, relief, timing (goes away when exertion stops)
- Characteristic background–risk factors
Patient could describe angina as?
Pressing, squeezing, heaviness, a weight
Radiating to arm, back, neck, jaw and teeth
Causes=Exertion stress, cold wind, after meals
Few minutes of rest relief it
Patient symptoms which indicate muscuoskeletal pain?
Dull, knifelike stabbing Fleeting or prolonged Focal- left submammary in shoulder No pattern, can be at rest No risk factors
Differential diagnosis fro chest pain relating to the GI tract?
Reflux, burning, acid, water brash- provoked by food
Peptic ulcer pain- boring,Point of ginger gesture,relief by antacids
Oesophageal spasm
Biliary colic
Differential diagnosis for chest pain in regards to musculoskeletal pain?
Injury- location, prolonged, exact
Nerve root pain- prolonged, character
Other differential diagnosis of chest pain?
Pericarditis - central, posture related
Pleuritic pain- focal exacerbated by breathing, sharp/catching
Emergency syndromes?
Myocardial Infarction - prolonged, severe
Pulmonary Embolus - breathlessness, dull
Dissection of aorta - tearing,excruciating, severe then eases
If a patient described what would it be?
Pressing pain in exercise but can resume after 5 mins
Angina
Angina can be tested for. True or False?
False. Angina is a CLINICAL diagnosis
