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Pre > Ischemic Heart Disease(IHD) > Flashcards

Ischemic Heart Disease(IHD) Flashcards

1
Q

Also called:
Coronary Heart Disease(CHD),
Coronary artery disease (CAD)
Atherosclerotic heart disease

A

Ischemic Heart Disease

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2
Q

condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium

typically occurs when there is an imbalance between myocardial oxygen supply and demand

A

Ischemic Heart Disease

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3
Q

blockage or narrowing (stenosis) of the arteries that supply the heart muscle, often due to a buildup of fatty plaque inside the arteries.

A

Coronary Artery Disease

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4
Q

In majority of patients, it is caused by atherosclerosis

A

Coronary Artery Disease

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5
Q

rarely may be due to aortitis

A

Coronary Artery Disease

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6
Q

rarely may be due to vasculitis

A

Coronary Artery Disease

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7
Q

rarely may be due to autoimmune connective tissue diseases

A

Coronary Artery Disease

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8
Q

Heart rate
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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9
Q

Blood pressure
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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10
Q

Myocardial contractility
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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11
Q

L. Ventricular hypertrophy
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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12
Q

Valve disease e.g aortic stenosis
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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13
Q

Duration of diastole
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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14
Q

Coronary perfusion pressure
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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15
Q

Coronary vasomotor tone
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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16
Q

Oxygenation
- haemoglobin
- O2 saturation
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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17
Q

• Chest pain or heaviness
• Dyspnoea: exertional, orthopnoea,
paroxysmal nocturnal dyspnoea
• Ankle swelling
• Palpitations
• Syncope
• Intermittent claudication
• Fatigue

Are common symptoms of

A

Ischemic heart disease

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18
Q

Chest pain or heaviness

A

A common symptom of ischemic heart disease

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19
Q

Dyspnoea: exertional, orthopnoea,
paroxysmal nocturnal dyspnoea

A

A common symptom of ischemic heart disease

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20
Q

Ankle swelling

A

A common symptom of ischemic heart disease

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21
Q

Palpitations

A

A common symptom of ischemic heart disease

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22
Q

Syncope

A

A common symptom of ischemic heart disease
+ a sign of cardiovascular diseases

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23
Q

Intermittent claudication

A

A common symptom of ischemic heart disease

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24
Q

Fatigue

A

A common symptom of ischemic heart disease

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25
Q

Cardiac arrest

A

A sign of cardiovascular diseases

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26
Q

Abnormal heart sounds/Murmurs

A

A sign of cardiovascular diseases

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27
Q

Signs of heart failure

A

A sign of cardiovascular diseases

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28
Q

Cardiac arrhythmias

A

A sign of cardiovascular diseases

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29
Q

Normal physical exam doesn’t exclude

A

IHD

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30
Q

usually occurs on exertion and is relieved by the rest

A

Angina Pectoris

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31
Q

Typically described as a central, squeezing, pressure, heaviness, tightness or pain in the chest.

A

Angina Pectoris

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32
Q

Pain may radiate to the jaw, neck, or one or both arms and may be associated with shortness of breath

A

Angina Pectoris

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33
Q

term that encompasses both unstable angina and myocardial infarction

A

Acute coronary syndrome (ACS)

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34
Q

characterized by
new-onset or rapidly worsening (crescendo ……….)
on minimal exertion or at rest in the absence of myocardial damage

A

unstable angina

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35
Q

Fixed stenosis
Demand-led ischemia
Related to effort
Predictable
Symptoms over long term

A

Stable angina

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36
Q

Dynamic stenosis
Supply-led ischemia
Symptoms at rest
Unpredictable
Symptoms over short term

A

Unstable angina

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37
Q

Mild chest pain for less than 15 minute and occurs with exertion, with rapid relief once the patient rests, or by taking sublingual nitrate

A

Stable angina

38
Q

The amount of exertion necessary to produce the pain
Is in

A

Stable angina

39
Q

May progress to Unstable Angina

A

Stable angina
So the change in the pattern ,severity or character of it must be taken very seriously

40
Q

Chest pain of moderate to severe degree occurs at rest or wakes up a patient from sleep
Stays for more than 15 minutes

A

Unstable angina

41
Q

not relieved by rest or sublingual nitrate

A

Unstable angina

42
Q

Have to deal with it as seriously as acute MI, patient should be admitted to CCU

A

Unstable angina

43
Q

Site: retrosternal, radiates to arm, epigastrium, neck

Precipitated by exercise or emotion

Relieved by rest, nitrates

Mild/moderate severity chest pain

Anxiety absent or mild

No increased sympathetic activity

No nausea or vomiting

A

Angina

44
Q

Site: retrosternal, radiates to arm, epigastrium, neck

Often no obvious precipitant

Not relieved by rest, nitrates

Usually severe chest pain(may be ‘silent’)
Severe anxiety
Increased sympathetic activity

Nausea and vomiting are common

A

MI

45
Q

Painless or ‘silent’ myocardial infarction is not uncommon, particularly in

A

diabetic patients and the elderly

46
Q

A sign of ischemic chest pain

A

Levine’s sign

47
Q

Clenching of fist in front of chest while describing chest discomfort

A

Levine’s sign

48
Q

Ischaemia due to fixed atheromatous stenosis of one or more coronary arteries

A

Stable angina

49
Q

Ischaemia caused by dynamic obstruction of a coronary artery due to plaque rupture or erosion with superimposed thrombosis

A

Unstable angina

50
Q

Myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture or erosion with superimposed thrombosis

A

Myocardial infection

51
Q

Myocardial dysfunction due to infarction or ischaemia

A

Heart failure

52
Q

Altered conduction due to ischaemia or infarction

A

Arrhythmia

53
Q

Ventricular arrhythmia
asystole
massive mvocardial infarction

A

Sudden death

54
Q

DM-insulin resistance

A

A modifiable risk factor for IHD

55
Q

Hypertension

A

A Modifiable Risk factor for IHD

56
Q

Smoking

A

A Modifiable Risk factor for IHD

57
Q

Hyperlipidemia

A

A Modifiable Risk factor for IHD

58
Q

Alcohol

A

A Modifiable Risk factor for IHD

59
Q

Obesity

A

A Modifiable Risk factor for IHD

60
Q

Sedentary lifestyle

A

A Modifiable Risk factor for IHD

61
Q

Diet

A

A Modifiable Risk factor for IHD

62
Q

Age 45 yrs or more

A

An Unmodifiable Risk factor IHD

63
Q

Male gender

A

An Unmodifiable Risk factor IHD

64
Q

History of previous IHD

A

An Unmodifiable Risk factor IHD

65
Q

Family history of IHD

A

An Unmodifiable Risk factor IHD

66
Q

Serial ECGs

A

Investigation of Acute Coronary Syndromes

67
Q

Serial cardiac markers

A

Investigation of Acute Coronary Syndromes

68
Q

Oxygen

A

Prehospital care of Acute Coronary Syndromes

69
Q

aspirin

A

Prehospital care of Acute Coronary Syndromes

70
Q

nitrates

A

Prehospital care of Acute Coronary Syndromes

71
Q

triage to an appropriate medical center

A

Prehospital care of Acute Coronary Syndromes

72
Q

Prehospital care of Acute Coronary Syndromes

A

Oxygen, aspirin, and nitrates and triage to an appropriate medical center

73
Q

Drug treatment of Acute Coronary Syndromes

A

Analgesics,antiplatelet drugs, antianginal drugs, anticoagulants,

74
Q

Analgesics

A

Drug treatment of Acute Coronary Syndromes

75
Q

antiplatelet drugs

A

Drug treatment of Acute Coronary Syndromes

76
Q

antianginal drugs

A

Drug treatment of Acute Coronary Syndromes

77
Q

anticoagulants

A

Drug treatment of Acute Coronary Syndromes

78
Q

Angiography

A

assess coronary artery anatomy

79
Q

Reperfusion therapy includes ……
Used for …….

A

Fibrinolytics, percutaneous coronary intervention or coronary artery bypass
surgery
Used for Management of Acute Coronary Syndromes

80
Q

Fibrinolytics

A

Reperfusion therapy

81
Q

percutaneous coronary intervention

A

Reperfusion therapy

82
Q

coronary artery bypass
surgery

A

Reperfusion therapy

83
Q

Supportive care includes …….
Used for ……

A

Post-discharge cardiac rehabilitation and chronic management of coronary artery disease

Management of Acute Coronary Syndromes

84
Q

Anti-platelet therapy (aspirin +/ clopidogrel)

A

MI 2ry prevention drug therapy

85
Q

Beta blocker

A

MI 2ry prevention drug therapy

86
Q

ACE inhibitors/ ARB

A

MI 2ry prevention drug therapy

87
Q

Statin

A

MI 2ry prevention drug therapy

88
Q

Additional therapy for control of diabetes + HT

A

MI 2ry prevention drug therapy

89
Q

Mineralocorticoid receptor antagonist

A

MI 2ry prevention drug therapy

90
Q

if there is HF or pulmonary congestion

A

Auscultate Basal crepitations

91
Q

if R. Ventricular hypertrophy is present

A

left ventricular heave may feel

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