IHD

Question 1

Definition of Ischemic Heart Disease

Answer 1

narrowing of one or more coronary arteries due to atherosclerosis

Question 2

Main Types of Cardiovascular disease

Answer 2

IHD
cerebrovascular disease (CVD)
peripheral arterial disease (PAD)
venous thromboembolic disease (VTE)
Heart failure
arrhythmia

Question 3

Types of Acute Coronary Syndrome

Answer 3

unstable angina
NSTEMI
STEMI

Question 4

What is unstable angina

Answer 4

inadequate “supply regardless of demand”
blockage without cardiac cell death

Question 5

What is stable angina

Answer 5

dull ache in the chest
problem of “demand exceeding supply”

Question 6

What is fixed obstruction angina

Answer 6

increase demand that cannot be accommodated with increase supply

Question 7

What is affected of coronary atherosclerosis?

Answer 7

increase of demand
increase HR, BP, contractility, venous return

Question 8

What are some triggers for stable angina

Answer 8

SNS activity
exertion after a heavy meal
metabolic demands
anemia

Question 9

What is the definition of fixed obstructions in the heart?

Answer 9

if epicardial vessels obstructed
it will cause the heart muscle to not get enough blood

Question 10

What is it if the chest pain is relieved by rest

Answer 10

it is stable angina
you will see ST segment depression

Question 11

What are the different ECG to look for?

Answer 11

ST segment depression (ischemia)
ST segment elevation (infarction)
QT interval

Question 12

T or F a normal QT is normal in a healthy patient

Answer 12

no it is not normally seen
if you can see it ventricular de/repolarization is off
(evidence of the past heart attack)

Question 13

T or F Stable angina is not an emergency

Answer 13

True

Question 14

What are the core meds after a ACS?

Answer 14

Antiplatelet
Blood pressure
Cholesterol lowering
K-CKD
Diabetes
Exercise (lifestyle)

Question 15

What is primary prevention?

Answer 15

before a cardiac event

Question 16

What is secondary prevention?

Answer 16

stopping the next cardiac event

Question 17

What is first line for prevention of angina?

Answer 17

metoprolol (BB)
nitro to treat pain PRN

Question 18

What is the second line for prevention of angina?

Answer 18

Metoprolol + NTG patch
Metoprolol + amlodipine (if BP increased)
increase metoprolol
switch to add on ranolazine

Question 19

When is ACE used with stable?

Answer 19

helps with pt. who have low EF, HTN, CKD

Question 20

List what drugs are part of antianginal therapy

Answer 20

BB
DHP-CCB
Non-CCB
nitrates
ranolazine

Question 21

When is BB and DHP CCB CI?

Answer 21

heart block (AV block) can be a consequence and CI

Question 22

Ways to treat coronary atherosclerosis

Answer 22

CABG
PCI
fibrinolytic medications

Question 23

Explain CABG

Answer 23

coronary artery bypass
- bypass graft to create a new path
-requires open heart surgery

Question 24

Explain PCI

Answer 24

percutaneous coronary intervention
-mesh tube to open the artery

Question 25

When is fibrinolytic medications used for CA?

Answer 25

for acute emergencies -myocardial infarction

Question 26

After PCI he needs DAPT

Answer 26

dual antiplatelet therapy ASA +ADPi

Question 27

List the ADP inhibitors

Answer 27

ticagrelor clopidogrel prasugrel

Question 28

What are the two types of stents?

Answer 28

bare metal stents drug eluting stents

Question 29

Why are drug eluting stents used?

Answer 29

usually immunosuppressants to decrease inflammatory cytokines and cell proliferation following stent implantation

Question 30

Role of DAPT is a key question in ACVP

Answer 30

long DAPT = increase risk of bleeding short DAPT = increase risk of events

Question 31

What should be Monitored with DAPT

Answer 31

clinical signs of bleeding (hematemesis, blood stool, bruising) generally tolerability (GI upset) Lab test (RBC, platelet count)