Ischemia Heart Disease 2/20 Flashcards
Test 2
IHD =
Ischemic heart disease
____% of Sx pts are at increased risk for IHD
30%
What are the 2 most important risk factors for developing IHD or atherosclerosis involvinf the coronaries?
Male gender
Increasing age
What are the first manifestations of IHD?
Angina pectoris
Acute MI
sudden death
What are things that can result in sudden death?
CAD
overdose
cardiomyopathy
Stable angina is also known as _________
Angina Pectoris
Stable angina is relieved by _______
rest
Stable angina is an imbalance between what?
Decreased coronary blood flow & increased myocardial O2 demand
Stable angina is ______ occlusion/narrowing w ____% being affected
partial
> 70%
What mediators are released with stable angina?
adenosine & bradykinin
stable angina affects the _______ sympathetic ganglia
T1 - T5
What type of CV changes are expected in stable angina? Why?
Increased risk for bradyarrhymthias
Decreased HR and contractility
Decreased flow thru coronaries –> decreased flow AV nodes –> decreased contractility and HR
_________ is the most common cause of impaired coronary blood flow resulting in angina pectoris
atherosclerosis
What are populations that you may see weird presentation with CP in?
DM
female gender
Where does retrosternal CP often radiate to?
dermatomes from C8 to T4
Which can then radiate to:
neck
left shoulder/arm
jaw
back
down both arms
T/F: Cold weather can induce angina
T
Differentiate between Chronic stable, unstable, and new onset angina
Chronic: No change in severity/frequency
> 2 months
Unstable: Increasing severity/frequency
-no change in cardiac biomarkers
New onset: Severe, prolonged, disabling
What can cause chronic stable angina?
distal occlusion
If CP is increasing in frequency/severity w increase in cardiac biomarkers WITHOUT EKG changes then…
NSTEMI
T/F: ECHO is useful in patients with confirmed AMI Dx
F
Only needed when Dx is uncertain with abnormal EKG
Your T wave is _____ from previous MI. What happens to it during a reccurent MI? What is this called?
inverted
If having another MI, T wave may go back to upright position
Pseudinormalization of T wave
Exercise ECG is ______ sensitive/specific than nuclear/chemical cardiology techniques
less (75%)
What is the most thorough/greater sensitivity test for coronary perfusion or IHD? What does it assess?
Nuclear (Chemical) stress imaging
Exercise or cardiac stress is produced by administration of: atropine, dobutamine, pacing, adenosine, dipyridamole –> radionunuclide tracer scanning is performed to asses myocardial perfusion.
Helps to also figure old vs new MI problems
-estimates LV size/function
What is the gold standard for assessing the coronaries?
Coronary angiography