Ischemic heart disease

Question 1

Crack cocaine use can cause a —-feeling. Gastric issues can also lead to —

Answer 1

“heart attack”

chest pain that feels comparable.

Question 2

—- is the main cause of coronary artery disease

Answer 2

atherosclerosis

Question 3

Cause of Atherosclerosis -

Answer 3

unknown, usually htn.

Question 4

ischemic heart disease -

Answer 4

pretty much when you start having symptoms.

Discomfort from not having enough O2 to heart muscle. We don’t know why this hurts.

Question 5

“Mowing half yard until chest pain when before it was the whole yard”

Changing character

Answer 5

• pain is more intense or lasts longer. Normal amount of rest/nitro doesn’t work, or the pain can radiate.

Poor prognosis - sign of impending MI.

Question 6

Unstable Angina characteristics

Answer 6

Precipitated by effort or rest Changing character
Difficult resolution
Poor prognosis

Question 7

Progressive angina

Answer 7

unstable - Progressive - thrombus or clot here that is not going to end well.

Question 8

Reversible angina

Answer 8

stable - because symptoms can be handled.

Question 9

Nitrates decrease

Answer 9

cardiac load - doesn’t need to work as hard. That is the idea of a venodilator.

Question 10

Beta blockers

Answer 10

Decrease HR & contractility

Question 11

Antiplatelet therapy

Answer 11

Aspirin +/- Clopidogrel

Question 12

drug eluting stents The metal has polymer on it that has a variety of drugs on it that prevent re-stenosis. These patients are placed on ——- for up to a year. The epithelium doesn’t like to heal over on these and it can take time.

Answer 12

dual antiplatelet therapy

Question 13

Unstable coronary syndrome - if something occured less than a

Answer 13

month ago*** a month is key here. MIs can knock out conduction system. As such, these patients are at increased risk for an arythmia. If more than 1 month ago, they are under “History of ischemic disease.” If you are on 1 month, look at compliance, rehab, etc.

Question 14

If less than 90 SBC, NO

Answer 14

NITRO. They will pass out and it will decrease SBP even more.

Question 15

Cutoff point for 911

Answer 15

. If pain is different, rest and nitro not working, call. Symptoms are different based on gender sometimes. Bad diabetics will have silent MIs. Cardinal chest pain, sweating, nausea all good signs. Chew and swallow the aspirin so that the pill is metabolized ASAP