Ischaemic heart disease

Question 1

What are the 2 main surgical treatments for ischaemic heart disease?

Answer 1

Coronary Artery Bypass Surgery
Percutaneous coronary intervention

Question 2

What is involved in preparation for Coronary Artery Bypass Surgery?

Answer 2

Median Sternotomy
Cardioplagia (Drugs used to stop or slow heart)

Question 3

What are some complications of Coronary Artery Bypass Surgery?

Answer 3

Risk of death = 1-2%
Risk of Stroke = 2-3%
Risk of MI = 3%
Atrial Fibrillation
Infection
Cognitive impairment
Sternal malunion (Healing disturbances after median sternotomy)
Renal failure
Failure to recover

Question 4

What occurs during percutaneous coronary intervention?

Answer 4

Anti-platelet and anti-coagulant drugs are given
A catheter is inserted to the coronary ostium
A guide wire is passed along the vessel
A balloon is threaded over the wire, and then the stent
The balloon is inflated, opening the stent

Question 5

What are some complications of percutaneous coronary intervention?

Answer 5

Risk of death = 0.8%
Risk of Stroke = 0.6%
Risk of MI = 1-2%
Renal failure
Bleeding
vascular complications
Risk of stent thrombosis
Risk of stent restenosis

Question 6

When would an angiography by given in a patient at high risk of MI?

Answer 6

STEMI - Immediately given PCI <30 minutes after arrival
NSTEMI - During hospital administration

Question 7

What are the 4 types of angina?

Answer 7

Stable angina
Unstable angina
Prinzmetal/Vasospastic angina
Microvascular angina