IHD Flashcards
What does CHD stand for?
Coronary Heart Disease
CHD is a general term that encompasses various phases of heart disease.
What are the phases included in Coronary Heart Disease?
- Asymptomatic disease
- Stable angina
- Progressive angina
- Unstable angina (UA)
- Non–ST-segment elevation MI (NSTEMI)
- ST-segment elevation MI (STEMI)
These phases represent the progression of ischemic heart disease.
What is angina pectoris?
Chest pain caused by accumulation of metabolites resulting from myocardial ischemia
The pain typically radiates to the chest, neck, jaw, and arms.
What is the most common cause of angina?
Atheromatous obstruction of the large coronary arteries, also known as Coronary Artery Disease (CAD).
What characterizes effort (stable) angina?
Pain on exertion due to inadequate blood flow in the presence of CAD.
What is vasospastic angina also known as?
Variant or Prinzmetal angina.
What occurs during unstable angina?
Chest pain occurs at rest with increased severity, frequency, and duration, requiring hospitalization.
What is the primary pathology associated with unstable angina?
Platelet-fibrin thrombus associated with a ruptured atherosclerotic plaque without complete vessel occlusion.
What are the three groups of drugs traditionally used to manage angina pectoris?
- Organic nitrates
- β-blockers
- Calcium channel blockers (CCBs)
What is the purpose of pharmacological management in angina?
To improve myocardial perfusion (↑ supply) and/or reduce metabolic demand (↓ demand).
What are the methods of coronary re-vascularization?
- Surgical re-vascularization (CABG)
- Catheter-based revascularization (PCI)
What is the recommended short-term treatment for stable angina symptoms?
Short-acting sublingual GTN for preventing and treating episodes of angina.
What daily medication is considered for long-term prevention of angina symptoms?
Aspirin 75 mg daily.
What is the mnemonic for chronic stable angina management?
A = Aspirin and Antianginal Therapy
B = β-Blocker and Blood Pressure
C = Cigarette Smoking and Cholesterol
D = Diet and Diabetes
E = Education and Exercise
What is the treatment for vasospastic angina?
Nitrates and CCBs for relief and prevention of ischemic episodes.
What characterizes acute coronary syndrome (ACS)?
Encompasses unstable angina and myocardial infarction (MI).
What is the defining characteristic of unstable angina?
Attacks that are increasingly frequent and/or prolonged, occurring at rest.
What symptoms are indicative of myocardial infarction (MI)?
Symptoms occurring at rest with evidence of myocardial necrosis.
What are common clinical features of ACS?
- Severe retrosternal pain
- Radiation to arms, neck, or jaw
- Tightness, heaviness, or constriction in the chest
- Breathlessness, vomiting, sweating, collapse
What are the expected complications of ACS?
- Sudden death from VF or asystole
- Development of heart failure
What initial management strategy is used in ACS?
MONA-B +/- Reperfusion.
What is the primary treatment for STEMI?
Immediate re-perfusion therapy (antiplatelet + anticoagulants) + PCI or thrombolytics.
What is the duration for dual antiplatelet therapy (DAPT) after MI?
12 months.
What medication should be initiated for patients with LVSD (EF < 40%) after MI?
Aldosterone antagonists.
What is the best medication regimen for a 62-year-old man with chest pain and ST-segment elevation?
Unfractionated heparin (UFH) infusion.
Which medications are appropriate for a 55-year-old woman with NSTEMI upon discharge?
- Statin
- β-blocker
- Aspirin
- Clopidogrel
- Spironolactone
What medications should be avoided in treating vasospastic angina?
β-blockers.
