Lecture 1: Introduction Flashcards
what is CAD
blockage that limits coronary blood flow but doesn’t inhibit mm function
CAD undetected until 70% occlusion
*coronary heart disease = blockage that causes permanent myocardial damage and inhibits function
what is atherosclerosis and what are the components that make up “atherosis” and “sclerosis”
Atherosis
1. lipids accumulate between intimate and endothelial layers
- plaque grows and separates layers
Sclerosis
3. platelet accumulation and thrombus formation
primary atherosclerosis risk factors
smoking
HTN
sedentary
high cholesterol
values that constitute high cholesterol
LDL >100-120
HDL <35
triglycerides >200
secondary atherosclerosis risk factors
diabetes
obesity
family hx
age
gender
stress
modifiable risk factors of atherosclerosis
Metabolic:
-HTN
-high BMI
-diabetes
-kidney dysfunction
-high LDL
Behavioral
-diet
-smoking
-alcohol consumption
-physical activity
Environmental:
-air pollution
-stress
non-modifiable risk factors for CAD
age
sec
ethnicity
genetic factors
what happens as atherosclerosis progresses
increased permeability of endothelial layer
increased leukocyte activation
decreased anti-clotting properties of vasculature
fibrous cap develops over lipid core
decreased plaque stability
thrombus formation over injured endothelial tissue
plaque can dislodge or occlude coronary arteries
ways to prevent CAD
ASCVD risk estimator tool
encourage medical intervention
wellness/lifestyle modification
smoking cessation
low cholesterol and salt diet
physical activity
awareness and edu
causes of angina
Common:
vasoconstriction
thrombosis
atherosclerosis
endothelial dysfunction
vasospasm
other:
acute respiratory failure
cardiogenic/septic shock
hemorrhage
hypovolemia
severe HTN
aortic stenosis
stable vs unstable angina
stable
- at fixed point
- reproducible with exertion
- goes away when stopping activity
- <5 min
unstable
- at rest or with minimal exertion
- doesn’t go away
- >10 min
what is prinzmetal/variant angina
coronary artery vasospasm
very uncommon
has different risk factors/not related to PAD
key distinctions between angina and other types of chest pain
angina = reproducible with aerobic exertion, eating, emotional stress, and cold temps
angina is relieved with nitroglycerin
angina is not reproducible with typical ortho exam unless there is an exertional component
some pts have impending sense of doom; sudden cardiac death is 1st symptom in 40% cases
most common MI warning signs
pressure, fullness, squeezing, or pain in center of chest
pain that spreads to throat, neck, back, jaw, shoulders, or arms
chest discomfort with lightheadedness, dizziness, sweating, pallor, SOB
prolonged S&S unrelieved by antacids, nitroglycerin, or rest
atypical MI warning signs
unusual chest, stomach, abdominal pain
continuous midthoracic or inter scapular pain
continuous neck/shoulder pain
isolated R bicep pain
pain relieved by antacids; unrelieved by rest or nitroglycerin
N&V; flu like malaise
unexplained anxiety, weakness, or fatigue
breathlessness, dizziness
