IHD Flashcards
1
Q
What causes IHD?
A
Atherosclerosis
2
Q
What are the risk factors of IHD?
A
- Obesity
- Smoking
- Lack of exercise
- Hypertension
- Diabetes
- Hypercholesteraemia
- Poor diet
- Excess alcohol
- Rheumatological disease
- RA
- SLE
- Psoriasis
- Psoriatic arthritis
3
Q
Outline the pathophysiology of IHD
A
- Atherosclerosis forms from endothelial injury of the vessel
- Proliferation of smooth muscle cells
- This exposes the lipid laden vessel which become oxidised
- This causes macrophage to come and engulf the lipid and become foam cells
- Foam cells accumulate in intima of blood vessel walls to form a fatty streak
- Fatty streaks can evolve into athersclerotic plaque
- Grows and encroaches on the lumen of the artery
- The plaque ruptures
- This triggers acute thrombosis by activating platelets and clotting cascade
4
Q
What are the types of acute coronary syndrome?
A
Stable angina
Unstable angina
MI
Sudden cardiac death
5
Q
What are the signs and symptoms of IHD?
A
- Asymptomatic
- Central crushing chest pain
- Radiation of pain to the arm, neck, jaw and back
- Heartburn
- SOB
6
Q
How would you investigate IHD?
A
- ECG
- Cardiac stress test - exercise tolerance tet
- Cardiac enzymes
- Echo (+stress)
- Coronary angiogram
7
Q
How should IHD be managed?
A
- Lifestyle changes
- Quit smoking/alcohol
- Exercise
- Eat better
- Optimise HTN and diabetes
- Medication
- Antiplatelets - aspirin and clopidogrel
- Statins
- Beta-blockers - HTN
- GTN
- Surgery
- PCI
- CABG
8
Q
What are the possible complications of IHD?
A
- MI
- Heart failure
- Arrythmia
