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LV Function and Ischemic Heart Disease > Ischemic or CHD Pt 1 > Flashcards

Ischemic or CHD Pt 1 Flashcards

1
Q

An insufficient supply of oxygenated blood results in what?

A

Ischemia

Blockage of coronary artery(s) results in damage/injury

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2
Q

What is ischemia seen on an EKG as?

A

ST depression

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3
Q

Cell death or necrosis is a result of ______

A

MI (myocardial infarction)

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4
Q

MI is seen on an EKG as an ________

A

ST elevation

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5
Q

What is the leading cause of death in the US?

A

MI

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6
Q

What does a ST segment greater than 1mm indicative of?

A

That there is an acute evolving MI

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7
Q

Ischemia may involve an inverted what on EKG?

A

T wave

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8
Q

What is a visible Q on EKG indicative of?

A

A previous infarction

The Q wave remains abnormal due to scar formation

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9
Q

What are the non-modifiable risks?

A

Advancing Age
Gender- especially men and post menopausal women
Family History

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10
Q

What are the modifiable risk factors?

A 
Diabetes
Smoking
HTN
High Cholesterol
Obesity
Sedentary Lifestyle
Stress
Over Consumption of Alcohol
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11
Q

What are causes of Ischemic Heart Disease?

A 
Atherosclerosis
Thrombosis 
Coronary Spasm
Decreased Coronary Flow
Abnormal Coronary Artery Development
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12
Q

What is the inflammatory process?

A

Gradual build up of atherosclerotic material
damages arterial walls.
-WBCs respond- inflammatory response further damages walls allowing LDL molecules to infiltrate.
-Fatty (lipid) streak develops. May harden and narrow vessel or may rupture.
-Response to rupture is blood clot formation, may further obstruct artery OR plaque may embolize & block smaller arterial branch.
Ischemia or MI

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13
Q

What is angina pectoris?

A

Chest pain due to myocardial ischemia

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14
Q

Stable angina pectoris?

A

effort induced
short lasting
relieved by rest or NTG

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15
Q

Unstable Angina (USA) pectoris tends to?

A

Lasts longer
More often
Not always related to exertion
NTG temporarily relieves

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16
Q

Variant Angina is also known as

A

Prinzmetal’s Angina

17
Q

Variant Angina occurs?

A

At rest
Early in the Morning
Thought to be a coronary artery spasm

18
Q

What is Variant Angina often associated with on EKG?

A

ST segment elevation

19
Q

Besides angina, what are other symptoms associated with IHD?

A

Fatigue
Silent MI, an MI can be silent ( mild/non-existent symptoms)
Detection of a new murmur post MI
Sudden Death

20
Q

Detection of a new murmur post MI may be due to what?

A

MR due to pap muscle dysfx/rupture, VSD, LV dilation

21
Q

With sudden death up to what % is due to MI’s

A

35%

22
Q

What percentage have no symptoms prior to MI?

A

Up to 50%

23
Q

Men v Women

Symptoms for Men

A

Typical Chest pressure
pain radiating to neck, jaw, and left arm
nausea
sweating

24
Q

Men v Women

Symptoms for Women

A 
Chest pain
Profound fatigue
Chest- area pressure, constant/intermittent
SOA
Fast, weak pulse
Dizziness, fainting
Nausea
Sweating
25
Q 
-Relevant Facts for Women-
Kills more women annually than \_\_\_\_\_\_
More prevalent after \_\_\_\_\_\_\_
More likely than men to \_\_\_\_\_\_
More \_\_\_\_\_\_ than men's MI's
A

Breast CA+accidents+diabetes
Menopause
Die within one year of first MI
Damaging

26
Q

What are the Diagnostic tests for IHD/CAD

A 
Cardiac Cath
Echo
Stress Echo
Nuclear Stress Testing
EKG
Blood Tests: enzymes, or other markers
27
Q

Which diagnostic test is the Gold Standard for IHD/CAD?

A

Cardiac Cath

28
Q

Stress Echo

A

Evaluates functional response of heart by detecting WMA’s

29
Q

Nuclear Stress Test

A

Detects perfusion abnormalities

30
Q

Relevant Blood Tests

What cardiac enzymes increase with MI?

A 
Troponin
Creatinine Kinase (CK)  -CK-MB
Creatinine phosphokinase (CPK)
31
Q

What is bad cholesterol?

A

LDL

32
Q

What is good cholesterol?

A

HDL

33
Q 
Relevant Blood Tests 
Clotting Factors (Blood Clotting Time)
A

Prothrombin time (pro time, PT time, PTT, INR)

34
Q

Relevant Blood Tests

C-reactive protein (CRP)

A

An indicator/marker of inflammation in the body

35
Q

Clot Busters (thrombolysis)

A

Within 3 hours of onset of symptoms

  • Streptokinase
  • Urokinase
  • tPA (tissue plasminogen activator)
36
Q

Statins

A

Reduce cholesterol, triglycerides

37
Q

Nitrates

A

Vasodilators, CP relief

38
Q

Antiplatelets

A

Reduce clot formation

39
Q

Beta Blockers and Calcium Channel Blockers

A

Reduce workload of the heart

LV Function and Ischemic Heart Disease (2 decks)

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