Coronary Syndromes

Question 1

3 determinants of SV?

Answer 1

CAP: Contractility, Afterload, Preload

Question 2

How can a clinician measure preload?

Answer 2

Swan Ganz catheter measures pressure in pulmonary artery which is an estimate of preload

Question 3

What parameter tells you about the contractility of the heart?

Answer 3

EF

Question 4

You have “3 vessel CAD” what do you need?

Answer 4

Bypass surgery

Question 5

What are the 3 syndromes of coronary disease that we need to know?

Answer 5

1. Chronic stable angina
2. Acute coronary syndrome
3. ST elevation MI

Question 6

This coronary disease presents with DOE and is a supply < demand problem

Answer 6

Chronic stable angina

Question 7

What are the two determinates of myocardial O2 demand?

Answer 7

HR and Systolic BP

Question 8

How long does the pain of chronic stable angina last?

Answer 8

5-30 minutes

Question 9

EKG of subendocardial ischemia shows?

Answer 9

ST depression

Question 10

This coronary artery disease presents with “elephant sitting on my chest”

Answer 10

Acute coronary syndrome (ACS)

Question 11

What typically happens to cause ACS?

Answer 11

Rupture of vulnerable atherosclerotic plaque

Question 12

What % of the artery is blocked in ACS?

Answer 12

90%

Question 13

What happens with platelets in ACS?

Answer 13

The “run rampid” and clot up everywhere

Question 14

EKG in ACS?

Answer 14

Normal

Question 15

“Crushing, squeezing” sub-sternal chest pain radiating to left arm and jaw that lasts several hours. Whats the diagnosis?

Answer 15

MI

Question 16

Are the cardiac myocytes reversibly or irreversibly injured?

Answer 16

Irreversibly injured.. Necrosed.. Dead!

Question 17

% occlusion of coronary artery in MI

Answer 17

100%

Question 18

What labs are diagnostic for MI?

Answer 18

Troponin I and CK-MB

Question 19

EKG on MI?

Answer 19

ST elevation

Question 20

Best treatment for MI?

Answer 20

Cath lab- get a stent in and do angioplasty