IHD Flashcards
IHD RF/causes
smoking
htn etc
morphology
STEMI: full thickness
NSTEMI: partial thickness
UA: partial occlusion
SA: partial occlusion, adequate O2 except w/ exercise
typical ACS history
dull central crushing chest pain
gradual onset
exertion worse
SANS
typical ACS signs
xanthelasmata, tendon xanthoma
ACS differentials
MI/UA/SA pericarditis, myocarditis aortic dissection PE, GORD, pneumo, PTx, MSK ***MAAP PPP***
STEMI Mx
MONA
BROMANCE
NSTEMI/UA Mx
???bromance
Secondary prevention
A-SCAB ACEI statin clopidogrel aspirin beta-blocker
ACS complications
heart failure, haemoperi/tamponade systemic emboli, DVT/PE LVH, LV aneurysm, LV rupture, VSD papillary mm rupture, mitral regurg arrhythmias (tachy/brady), arrest pericarditis, Dressler's
Thrombolysis
indications:
contraindications: warfarin/heparin?
cardiac rehab
driving: Sx controlled and not at rest/emotion
employment: exercise tolerance, fatigue, infections, medication SE
causes and RF of SA
CAD VHD HCM tachyarryhtmia small vessel disease anaemia
smoking, fat, DM, HTN, male, age, exercise and diet
angina pathology
fatty streaks, endothelial damage and inflammation
foam cells and cytokines
intima muscularisation, media compression atrophy
hyaline fibrosis and enlargement
fibrous cap, calcification, fissuring
angina investigation
bloods and ECG: resting/exercise
scintography (perfusion), echo, and angiography
exclude precipitants: anaemia, DM, thyroid, GCA, lipids
treatments
lifestyle/RF aspirin: antiplatelet/occlusion beta-blockers: HR/BP; O2 requirement nitrates: vasodilation CCB: vasodilation +/- HR nicorandil (K-channel activator) ivrabradine (HR)
*prinzmetal: CCB + nitrates; not BB/aspirin
PCI (balloon + stent) or CABG
