Ischaemic Heart Disease Flashcards
What are the possible causes of chest pain?
Cardiac;
- MI
- Angia
- Pericarditis
Non-cardiac;
- Respiratory (Pneumonia, Pulmonary Embolism)
- GI (Oesophagus reflux, Spasm)
- MSK (Rib fracture, muscle spasm, Costochondritis)
Compare the types of chest pain
Cardiac/ Visceral;
- Dull, poorly localised pain
- Worsens with exercise
Pleuritic/ Somatic;
- Sharp, well localised pain
- Worsens with inspiration/ coughing/ movement
- Often involves irritation of pleura
What is Pericarditis?
What is the typical cause?
In which patient groups is it more common?
Which nerve innervates the pericardium
Inflammation of pericardium
Typically due to a viral illness
More common in men and adults
Phrenic nerve
What are 2 pain related symptoms of pericarditis
What are 2 things that make it worse and better
What may be heard on Auscultation
What may be seen on an ECG
- Well localised retrosternal chest pain
- Sharp pain, localised to front of chest
- Aggravated by inspiration/ coughing, lying flat
- Eased by sitting up and leaning forward
- May hear pericardial rub
- Widespread ST elevation (In all leads)
Why is visceral pain poorly localised
Visceral afferent fibres from heart travel to the spinal cord, where they mix, -> Less well-localised pain
The risk factors of IHD and what vascular condition are the same?
Atherosclerosis
In Stable Angina, when does Ischaemia occur?
Name 1 treatment for Stable Angina
Occurs when metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries
GTN spray- relives pain
(Venodilation)
What are 4 causes of stable angina
What are 3 clinical signs
Causes;
- Coronary artery stenosis
- Spasm
- Anaemia
- Severe Aortic valve stenosis
Signs;
- Dull, retrosternal chest pain
- Aggravated by exertion
- Relieved completely by rest
What is an Acute Coronary Syndrome?
Give 3 examples
A condition where acute Myocardial Ischaemia occurs, due to atherosclerotic coronary artery disease
- Unstable Angina
- NSTEMI
- STEMI
Compare the leak of enzymes in cardiac ischaemia and infarction
Ischaemia: No enzyme leak
Infarction: Enzyme leak from necrosed cells
What are 3 clinical signs of Unstable Angina
What may it eventually lead to
- Pain at rest
- Pain more intense (Than Stable)
- Pain may last longer (Than stable)
May deteriorate to MI (STEMI/ NSTEMI)
What are 3 clinical signs of MI
- Dull, retrosternal chest pain
- May radiate (To neck and shoulders)
- Patient looks unwell due to stimulation of SNS (Pallor, Sweating, Nausea, Dyspnoea_
Give 5 management methods of MI
- Give Oxygen
- Pain relief (Morphine)
- GTN spray (Nitrates)
- Aspirin
- Repurcussion (PCI, Coronary artery bypass)
What is Percutaneous Coronary Intervention (PCI)
Using a catheter to place a stent into a narrowed vessel
Give 5 pharmacological management methods of Angina (Stable/ Unstable)
- Aspirin (Prevent clots forming)
- Statins (Reduce LDL)
- Beta blockers (Lower BP and HR)
- Oral nitrates (Stable angina only)
- ACE Inhibitors (Lower BP)
