Ischemic heart disease

Question 1

Angina

Answer 1

CAD >75% narrowing, no myocyte necrosis
1) stable: 2/2 atherosclerosis, ST depression on ECG

2) Prinzmetal’s variant: occurs at rest 2/2 coronary artery spasm: ST elevation
3) Unstable/crescendo: thrombosis with incomplete coronary artery occlusions: ST depression

Question 2

Coronary steal syndrome

Answer 2

Vasodilator may aggrevate ischemia by shunting blood from area of critical stenosis

Question 3

MI

Answer 3

Most often due to thrombosis

EKG: initially ST depression then elevation with continued ischemia and transmural necrosis

Question 4

Sudden cardiac death

Answer 4

Death from cardiac causes within 1 hour of onset of symptoms
Most commonly due to lethal arrhythmias (Vfib)
Associated with CAD (up to 70%)

Question 5

Chronic ischemic heart disease

Answer 5

Progressive onset of CHF over many years due to chronic ischemic myocardial damage.