IHD: Prevalence, symptoms and treatment Flashcards
What is CVD
A disease of the heart and circulatory system which comprises: coronary heart disease, cerebrovascular disease and peripheral vascular disease.
What are some controllable risk factors for CHD
cigarette smoking, diabetes, high blood pressure, high cholesterol and obesity.
what are some non-controllable risk factors for CHD
Age, family history of premature coronary disease and previous heart attack
What is atherosclerosis
development of fatty streak in the arteries due to lipid deposition with intimal fibrosis.
IHD and myocardial ischaemia
IHD occurs due to atherosclerotic plaque build-up within one or more coronary arteries, obstructing myocardial blood flow.
this leads to an imbalance between myocardial oxygen supply and demand
restricts the normal increase in coronary blood flow which should occur in response to an increase in myocardial oxygen demand.
What are some clinical manifestations of IHD
May be asymptomatic, stable angina, acute coronary syndromes: unstable angina, NSTEMI, STEMI
Long term: Heart failure, arrhythmias, sudden death
What is stable angina
Ischaemia due to fixed atheromatous stenosis of one or more coronary arteries
What is unstable angina
ischaemia caused by dynamic obstruction of a coronary artery due to plaque rupture
What are the 3 types of chest pains
typical angina= retrosternal chest discomfort, provoked by exertion or emotional stress, relieved by rest and nitrated within minutes.
atypical angina= meets 2 of those characteristics
non-anginal chest pain= lack or meets only one or none of the characteristics.
What is the difference between STEMI and NSTEMI
ST-elevation is a marker of complete coronary occlusion.
NSTEMI- is a marker of incomplete coronary occlusion.
What are the classical symptoms of ACS
Classical: discomfort/pain in the centre of the chest that lasts for more than a few minutes.
pain radiating to other areas e.g. left arm/jaw/back
not relieved with sublingual GTN
elderly or diabetic patients often present with: breathlessness, nausea or vomiting, sweating and clamminess.
What are some medical managements of ACS
anti-platelet therapy: aspirin, clopidogrel
anti-ischemic therapy: nitrates
secondary prevention therapy: statin, ACEi, beta-blockers, smoking cessation and lifestyle modifications
What are the important rapid treatments for STEMI
Morphine/ nitrates for pain relief
antiplatelet agents and primary angioplasty to restore blood flow and clot-busting drug (when no accesss to primary angioplasty.
What is a cardiac biomarker for unstable angina
Troponin levels
