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CVS topics > IHD > Flashcards

IHD Flashcards

1
Q

What diseases are classified as ischaemic?

A

Angina and MI

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2
Q

what is the severity of IHD dependent on?

A

Duration of the ischaemia
The rate at which blood flow is reduced
The extent of blood flow decrease

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3
Q

What conditions can lead to IHD

A

Atherosclerosis and thrombosis

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4
Q

What factors increase the risk of formation of plaques?

A

*BAD HEART

Bmi
Age
Diabetes

Hypertension
Ethnicity
An increase in ldl decrease in hdl
Relatives
Tobacco

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5
Q

What is the physiological cause of IHD?

A
  1. Reduction in oxygen supply e.g
    Atherosclerosis
    Thrombosis
    Vasopasm
    Vessel inflammation
  2. Increase in demand e.g
    Tachycardia
    Thick myocardium
    Over exertion
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6
Q

What is mild transient ischaemia?

A

Angina pectoris

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7
Q

What is prolonged ischaemia

A

Myocardial infarction.
Irreversible damage leading to cardiac necrosis

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8
Q

What is stable angina

A
  1. When there is an obstruction in the artery so less blood flow
  2. Has a fibrous plaque so it does not rupture
  3. It is exercise induced
  4. Symptoms relieved by resting
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9
Q

What is unstable angina

A

-Caused by either a rupture of an atherosclerotic plaque which causes a plug formation or a thrombus
- induced at rest
- requires urgent treatment as it can lead to m.i

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10
Q

What is a Subendocardial infarction (NSTEMI)?

A

-caused by a rupture of a plaque or atherosclerosis
- developed at rest
- blood flow reduction is to the extent that cells can die
-PARTIAL OCCLUSION OF LUMEN
-30 minutes + of ischaemia

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11
Q

What is a transmural infarction (STEMI)?

A
  • caused by rupture of atherosclerosis plaque or a thrombus
    -develops at rest
    -blood flow reduced entirely
  • the ruptured plaque then blocks the whole lumen
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12
Q

What are the two treatment strategies of angina

A
  1. Drugs to reduce atherosclerosis i.e statins
  2. Drugs for pain and prophylaxis
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13
Q

What is the treatment aim of angina

A
  1. Increasing oxygen supply
  2. Decrease the demand
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14
Q

How do beta blockers help IHD

A
  • block the effect of catecholamines (noradrenaline and adrenaline) on the heart
  • reduce cardiac work so slower heart rate
    -reducing oxygen demand
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15
Q

Types of beta blockers

A

Atenelol
Metoprolol
Propanalol

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16
Q

What are beta blockers contraindicated in?

A

Asthma because of the b2 receptor activity

17
Q

What do organic nitrates do?

A

Vasodilators that act on the peripheral circulation
Reduce oxygen demand and preload increase supply

18
Q

What is the MOA of organic nitrates ie.GTN (DACPPV)

A

Danny Always Calls Puny Patrick Vile

Decompose to form NO
Activating guanlyl cyclase
CGMP is increased
Protein kinase G is activated
Proteins are phosphorylated
Vasodilation occurs

19
Q

What are common nitrates used

A

GTN (glyceryl trinitrate or nitroglycerin

isosorbide dinitrate/mononitrate

20
Q

When is GTN or isosorbide used?

A

GTN is used during an attack
Isorbide to prevent an attack

21
Q

A patient takes nitrate and is still experiencing pain why is that and how can this be solved

A

Anginal pain can become unresponsive to nitrates especially during prophylaxis so to combat this make sure the patient has drug free periods without GTN

22
Q

What do potassium channel openers do? E.g nicorandil

A
  1. Activates KATP channels
  2. Hyperpolarizes the membrane and reduces electrical excitability
23
Q

What is the secondary prevention of arterial thrombus formation?

A

75mg aspirin daily

24
Q

What is the management of unstable angina and MI

A

300mg aspirin
GTN

25
Q

What is the pharmacological treatment for acute myocardial infarction (MI)

A

300 mg of asprin
gtn spray
PCI
Fibrinolyctic drugs ie. Late pass to minimise cell death

26
Q

What are the three types of angina

A

Stable (plaque formation does not rupture)
Unstable (plaque rupture)
Variant (spasms)

27
Q

What does dual platelet antiplatelet therapy consist of?

A

Aspirin and clopidogrel (or ticagrelor and prasugrel) to prevent platelet formation and further attacks

28
Q

What are the three types of acute coronary syndromes

A

Unstable angina
NSTEMI
STEMI

29
Q

Which types of people is angina chest pain less common in?

A

Women
Elderly
Diabetics

CVS topics (6 decks)

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