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Cardio Exam 2 > lecture 8 > Flashcards

lecture 8 Flashcards

1
Q

When do you screen for primary prevention of CAD/CVA?

A

beginning at age 20 & repeated Q4-6 years in those without establisted or cerebrovascular disease

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2
Q

what does ASCVD stand for

A

atherosclerotic cardiovascular disease

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3
Q

what does CAD/CHD stand for?

A

coronary artery disease

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4
Q

what does CVA stand for?

A

cerebrovascular accident

stoke/TIA

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5
Q

why do you screen for primary prevention?

A

systematically identify risk factors for CAD/CVA-> provide 10-yr risk-> use data to encourage risk factor modification

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6
Q

if age 40-79 use

A
  • a 10-yr pooled cohort risk eqn to estimate short-term ASCVD risk
  • performs well in non-hispanic black & whites.
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7
Q

if age 20-39 or low risk (<7.5%) & age 40-59

A
  • use a 30-yr framingham score
  • provides more useful data t facilitate risk modification in young people since they may have low 10-yr risk despite risk factors (smoking, DM, HTN)
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8
Q

HTN primary prevention w/o compelling indications

A

ACEI/ARB or thiazide or CCB

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9
Q

HTN coronary artery disease

A

beta-blocker & ACEI/ARB

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10
Q

HTN recurrent stroke prevention

A

thiazide +/- ACEI

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11
Q

HTN CDK or DM

A

ACEI/ARB

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12
Q

systemic approach to assessment/prevention of CAD & CVA

A
  • HTN
  • dyslipidemia
  • DM
  • lifestyle
  • antithrombotic?
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13
Q

DM

A
  • lifestyle changes & pharmacological management w/ individualized A1C target
  • glycemic control does not generally reduce CV events but will prevent progression of microvascular complications (neuropathy, nephropathy, retinopathy
  • if impaired fasting glucose or glucose intolerance is present, perform lifestyle modifications to prevent progression to frank DM
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14
Q

Lifestyle

A
  • complete cessation of tobacco
  • obesity: target BMI 18.5-24.9 (10% in 6 mo)
  • diet
  • exercise: >40 mod intensity activity 3-4 days/wk
  • cardiac rehab: recommended for those with a history of CAD, esp after MI & chronic stable angina
  • alcohol: <1drink/day in women
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15
Q

antithrombotic approach will be specific to

A

the disease state, sex, age & risk of atheroembolic vs. cardioembolic events

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16
Q

atheroembolic events

A
  • where plaque rupture may/has caused a MI or stroke/TIA, therapy is spearheaded by antiplt agents
  • atheroembolic-> ASA
17
Q

cardioembolic events

A
  • where abnormal blood flow/inflammation/ endothelial damage puts you at risk od activation of clotting factors lead to a stroke/TIA (or DVT/PE) therapy is focused on anticoagulants
  • cardioembolic->coumadin
18
Q

atherosclerotic cardiovascular diease (ASCVD)

“silent”

A
  • > 50^ obstruction of coronary artery
  • chronic stable angina
  • carotid artery disease
  • PAD
19
Q

atherosclerotic cardiovascular diease (ASCVD) overt/”hard”

A
  • ACS

- stroke/TIA

20
Q

primary prevention

A
  • meaures taken to prevent onset of disease (decr or stop atherosclerosis leading to ASCVD)
  • i.e. prevent CAD/CSA/MI/stroke/TIA by controlling BP, dyslipidemia, tobacco abuse, lifestyle factors & potentially initiating antithrombotic therapy for high-risk pts (ASA)
21
Q

secondary prevention

A
  • measures taken to prevent recurrence/progression of diagnosed ASCVD
  • i.e. prevent CAD/CSA/MI/stroke/TIA by controlling BP, dyslipidemia, tobacco abuse, lifestyle factors & INITIATING antithrombotic therapy for ALL pts w/out CI
22
Q

CV risk

A
  • 5 fingers!
  • HTN
  • dyslipidemia
  • DM
  • lifestyle
  • antithrombotic
23
Q

coronary artery disease

A
  • arterial sclerosis leads to plaque rupture. plts play a large role in treatment & prevention hence antiplts (i.e. ASA/plavix/etc)
24
Q

atheroembolid stroke

A
  • arterial sclerosis leads to plaque rupture. plts play a large role in treatment & prevention hence antiplts (i.e. ASA/plavix/etc)
25
Q

cardioembolic stroke

A
  • abnormal flow/ inflammation/ endothelial leads to activation of clotting factors (anticoagulants for afib)
26
Q

MI

A

ASA +/- plavix, effient, brillinta

27
Q

DVT or PE

A

warfarin or xarelto

28
Q

atheroembolic stroke

A

plavix
aggrenox
ASA

29
Q

cardioembolic stroke (Afib or valve disease)

A

anticaogulant (warfarin, xarelto, eliquis, pradexa)

30
Q

DVT/PE or cardioembolic stroke (Afib or valve disease)

A
  • primary prevention
  • thrombo/cardioembolic
  • anticoagulant>antiplt
31
Q

MI or atheroembolic stroke

A
  • secondary prevention
  • atheroembolic event
  • antiplt>anticoagulant
32
Q

CHADSVASC score

A
  • C: congestive HF=1
  • H:HTN=1
  • A:Age>75=2
  • D:DM=1
  • S: stroke/TIA/embolism=2
  • V: vascular disease=1
  • A:Age65-74=1
  • Sc:Sex category (female)=1
33
Q

CHADSVASc therapy

A 
0= no therapy
1= ASA or anticoag
>/=2= anticoag
34
Q

calculate CHADSVASc score in pts with

A

atrial fibrillation

or valve replacement

Cardio Exam 2 (12 decks)

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