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Pharmacotherapy 4271 > IHD Part I > Flashcards

IHD Part I Flashcards

1
Q

this is chest pain new in onset, or involves a change in pattern, intensity or duration, compared with previous episodes in a patient with recurrent symptoms

A

acute chest pain

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2
Q

this type of chest pain is stable when symptoms are chronic and associated with consistent precipitants such as exertion or emotional stress

A

stable chest pain

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3
Q

what are some differential diagnosis of non cardiac chest pain?

A
  • pneumonia
  • bronchitis
  • dyspepsia
  • GERD
  • rib fracture
  • shingles
  • anxiety
  • panic disorders
  • hyperventilations
  • carbon monoxide poisoning
  • lead poisoning
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4
Q

true or false: these terms are all synonymous
- ischemic heart disease (IHD)
- coronary artery disease (CAD)
- coronary heart disease (CHD)
- atherosclerotic cardiovascular disease (ASCVD)

A

true

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5
Q

this refers to a decreased supply of oxygenated blood, for e.g. to the heart muscle. oxygen supply is insufficient to meet demands

A

ischemic

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6
Q

this is the medical term for chest pain due to IHD.

A

angina pectoris
aka: stable ischemic heart disease (SIHD) or chronic stable angina

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7
Q

this branch of heart issues includes ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndromes such as unstable angina (UA) and non-ST elevation myocardial infarctions (NSTEMI)

A

acute coronary syndrome (ACS)

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8
Q

what are some locations atherosclerotic vascular disease can occur

A
  • coronary arteries: coronary artery disease (CAD)
  • peripheral arteries (legs): peripheral artery disease (PAD)
  • cerebral or carotid arteries (in the brain): cerebrovascular disease
  • aortic atherosclerosis
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9
Q

these supply blood and oxygen to the muscles of the heart

A

coronary arteries

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10
Q

true or false: the right and left coronary arteries branch out as they go towards the bottom of the heart, therefore if there is a clot down towards the bottom of the heart it is more severe

A

false - the right and left coronary arteries branch out as they go towards the bottom of the heart, therefore if there is a clot towards the bottom of the heart it is less severe. if there is a clot towards the top of the heart, it will block the vessels below it affecting more of the heart therefore it will be more severe

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11
Q

does a plaque form in the lumen or the walls of a vessel

A

walls

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12
Q

this type of plaque in the walls of an artery has a thin fibrous cap, large lipid pools and many inflammatory cells

A

vulnerable plaque

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13
Q

how can a plaque in an artery wall lead to thrombotic occlusion

A

the body sees the plaque as an injury, so it forms a clot over the plaque and the clot can rupture. as this area heals the lumen becomes more narrow

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14
Q

what are some non-modifiable risk factors for IHD

A
  • age
  • sex
  • family history of premature CV disease
  • ethnicity
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15
Q

what are some modifiable risk factors for IHD

A
  • tobacco/alcohol use
  • dyslipidemia
  • HTN
  • abnormal BG / diabetes
  • chronic kidney disease
  • conditions of chronic inflammation
  • illicit drug use
  • physical inactivity
  • poor nutrition
  • obesity
  • stress
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16
Q

this is a hallmark symptom of IHD and is classically described as crushing, squeezing, tightness or like there is an “elephant on my chest”

A

chest pain

17
Q

where is cardiac chest pain usually located

A

substernal (below the sternum); pain may radiate to the LEFT arm, jaw, shoulder and back

18
Q

true or false: typical clinical presentation of IHD can be different in men

A

false - different in women

19
Q

what should be evaluated if a patient presents with chest pain?

A
  • focused history including characteristics and duration of symptoms
  • cardiovascular risk factor assessment
  • physical exam
20
Q

this is a CT scan that determines the amount of calcification in the coronary arteries; no contrast is used and it is used when a patient has other cardiac risk factors to determine their potential for acute events beyond the traditional risk factors
* a score of 0 has been shown to indicate the a patient has a very low risk of having a heart attack in the next 10 years

A

coronary artery calcium (CAC) score

21
Q

this pneumonic may be used to aid in the assessment of chest pain

A

“PQRST”
P - precipitating factors
Q - quality of the pain
R - region and radiation
S - severity of the pain
T - timing or temporal pattern

22
Q

this is a diagnostic test used for a patient presenting to a medical facility with acute chest pain. the goal is complete within 10 mins of arrival. helps to quickly identify serious/life threatening conditions.

A

standard 12-lead electrocardiogram (ECG)

23
Q

this is a cardiac test that looks at the anatomy of the coronary arteries. is it the gold standard for diagnosing CAD. accessed via radial or femoral artery. the catheter is advanced to the coronary circulation where a radio-opaque dye is injected and the flow is observed under fluoroscope

A

invasive coronary angiography (ICA) aka cardiac catheterization / cardiac Cath

24
Q

this anatomical test can visualize and help you diagnose the extent and severity of CAD, as well as plaque composition and high risk plaque features

A

coronary computed tomography anigoprapgy (CCTA)

25
Q

if a patient is asymptomatic (no acute chest pain), which cardiac test will be chosen

A

no testing

26
Q

if a patient has low risk of major CAD events, which cardiac test will be chosen for acute chest pain

A

no testing

27
Q

if a patient has intermediate risk of major CAD events, which cardiac test will be chosen for acute chest pain

A

anatomic of functional testing

28
Q

if a patient has high risk of major CAD events or has ACS, which cardiac test will be chosen for acute chest pain

A

invasive coronary angiography (ICA)

29
Q

what would the following be diagnostic of?

location: substernal with radiation down left arm

onset: sudden

quality: episodic, crushing, squeezing, tightness

quantity: severe pain, forcing patient to stop activity

associated symptoms: SOB

modifying factors: made worse by cold weather, exercise, or high emotion

*pain relieved by sublingual NTG or rest

A

angina pectoris

30
Q

what would the following be diagnostic of?

location: substernal with radiation down left arm

onset: sudden

quality: prolonged crushing, squeezing, tightness

quantity: severe pain, forcing patient to stop activity

associated symptoms: SOB

modifying factor: none, unremitting pain unaffected by sublingua NTG

A

unstable angina

31
Q

what would the following be diagnostic of?

location: substernal with radiation down left arm

onset: sudden

quality: prolonged crushing, squeezing, tightness

quantity: severe pain forcing patient to stop activity

associated symptoms: diaphoresis (sweating), N/V, SOB, syncope

modifying factors: none, unremitting pain unaffected by sublingual NTG

A

NSTEMI and STEMI

Pharmacotherapy 4271 (29 decks)

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