Ischemic heart disease Flashcards
What does cardiovascular disease consist of
1) Coronary Heart Disease
2) Cerebrovascular disease
3) Peripheral Vascular Disease
Atherosclerosis
Fatty streaks- plaques- rupture- cause thrombosis formation
Risk factors of CVD
Men, Older age, Family Hx, Htn, Hyperlipidemia, diabetes, smoking, obesity, alcohol, kidney disease, diet, left ventricular hypertrophy, hyperuricemia, cocaine, type A personality
Acute coranary syndrome (ACS)
Unstable angina
Non- ST elevation MI
What is a STEMI
ST Elevation MI– Transmural MI
Clinical pres of ACS
Gradual onset Worse with activity Discomfort not pain radiated to epigastrium, shoulders, arms or jaw usually lasts longer than 20-30 mins
Who likely presents with atypical symptoms
older
diabetic
women
What area of the heart does an ECG not directly examine
Right ventricle
Thrombolysis in myocardia infarction risk score
1) Age >64
2) At least 3 risk factors
3) Prior coronary stenosis >50%
4) ST deviation
5) 2 anginal episoides
6) cardiac markers
7) asprin use in last 7 days for CP
What TIMI scores mean
Likely hood of MI
0-1= low risk
2-3= intermediate risk
4-7 = high risk
Immediate assessment of ACS
1) Virals
2) IV access
3) 12 lead ECG
4) put on cardiac monitor
5) obtain a brief but detailed history and ohysical exam
6) blood for caridac markers
7) portable CXR <30 mins
What is MONA
M- Morphine- IV
O- Oxygen 2-4 L- keep stat >90%
N- Nitro- 0.4mg SL or IV
A- Asprin- 325 chewed
Describe anginal pain
retrosternal, pressure, radiation
Pain at rest correlates to what percentage of blockage
90%
How often do silent MI’s occur
25%
What medication has been shown to decrease mortality in MI patients at the time of infarct
asprin
What medications have been shown to decrease mortality after MI
Clopidogrel and a BB
Heparin is measured by which lab value
PTT
Warfarin is monitored by which lab value
PT-INR
What pathway does heparin use
intrinsic
what pathway does warfarin use
extrinsic
Most common coplication of MI
CHF
Compliction occuring 2 weeks after MI with chest pain relieved by leaning forward, muffled heart sounds
Dresslers
What percentage of blockage can produce symptoms of angina
70%
