Exam 2 - CHD Flashcards
Where does atherosclerosis happen?
in aorta and its branches
coronary arteries
cerebral arteries
Which chemical is protective to your vessels?
nitric oxide
What causes myocardial ischemia
significant coronary stenosis
What signs/sx might clue you in to the fact that a patient has ischemia?
MR
angina pectoris
What does stable angina present like in a male?
chest discomfort - heavy, tight, pressure, squeezing, burning, aching
Crescendo-decrescendo (1-5min)
Where does stable angina radiate to in a male?
L arm
upper back
upper arm
neck
jaw
teeth
What sign is represented by a fist over the sternal area?
Levine sign
What precipitates angina?
exercise
stress
cold
cigarettes
lg meals
How does angina present in a female?
atypical chest pain pattern
radiates to R arm
How does angina present in diabetic and elderly women?
malaise
dec appetite
abd discomfort
what does angina cause on the skin?
xanthelasma, xanthomas
what does angina cause in the eyes?
AV nicking
HTN and DM changes
what does angina look like on PE?
S4 gallop, murmurs, change in BP
What will ECG look like during an angina episode?
ST depression or T wave inversion
What’s the gold standard test for angina?
coronary angiography
does coronary vasospasm occur in normal or diseased arteries?
either
what causes coronary vasospasm?
exposure to cold, stress, meds/drugs
What are symptoms of coronary vasospasm?
chest discomfort at rest
What will you see on EKG with coronary vasospasm?
ST elevation
arrhythmias
What can a coronary vasospasm lead to?
MI
What is it called when a coronary vasospasm leads to ischemia?
Prinzmetal’s angina
When are you most likely to get sx from Prinzmetal’s angina?
at rest
in AM
does Prinzmetal’s vasospasm occur in normal or diseased vessels?
normal
What are the 3 criteria for unstable angina (NSTEMI)?
- angina at rest for >10min
- new onset angina (<4weeks) that is worsening
- previously stable angina that is worsening
Will you have cardiac marker elevation with a NSTEMI?
no
Switching gears to STEMI, what serum markers should you look for?
CK
troponin in 4-6 hours
What is the EKG criteria for using thrombolytics in a STEMI?
ST elevation > 1mm in 2 or more leads
ONLY
What might an acute MI lead to?
mitral regurg
LV dysfunction
ventricular arrhythmias
