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T2: Theme 3: CVS > Lecture 8: IHD > Flashcards

Lecture 8: IHD Flashcards

1
Q

What conditions made up cardiovascular disease?

A

Coronary heart disease

Cerebrovascular disease

Peripheral vascular disease

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2
Q

What are the controllable risk factors for CHD?

A 
Smoking
Diabetes
High BP
High cholesterol
Obesity
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3
Q

What are the non-controllable risk factors for CHD?

A

Age
Family history
Previous MI

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4
Q

What are the clinical manifestations of IHD?

A

Asymptomatic

Stable angina

ACS (unstable angina, NSTEMI, STEMI)

Long term (HF, Arrhythmias, sudden death)

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5
Q

What three characteristics must be met for a typical angina diagnosis?

A
  1. Substernal chest discomfort of characteristic quality and duration
  2. Provoked by exertion or emotional stress
  3. Relieved by rest and/or nitrates within minutes
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6
Q

What is the treatment for stable angina?

A

1st line: short acting nitrates, plus beta blockers or calcium channel blockers

2nd line: ivabradine, long acting nitrates

Consider angio: PCI (stent or CABG)

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7
Q

What are the acute coronary syndromes?

A

Unstable angina, acute MI (STEMI and NSTEMI)

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8
Q

What is the diagnostic blood marker for acute MI?

A

Troponin

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9
Q

What does ST elevation signify?

A

Complete coronary occlusion

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10
Q

What does incomplete occlusion look like on ECG?

A

ST depression, variable T wave abnormalities or a normal ECG

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11
Q

What are the classical symptoms of ACS?

A

Discomfort/pain in centre of chest that lasts for more than a few minutes or recurs

Discomfort/pain radiating to other areas

Can occur at rest or with exertion

Not relieved immediately with sublingual GTN?

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12
Q

How do elderly or diabetic people with ACS present?

A

Breathlessness

Nausea/vomiting

Sweating and clamminess

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13
Q

What are the anti-platelets used in ACS?

A

Aspirin (300mg loading dose then 70mg)

Clopidogrel/prasugrel

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14
Q

What is the anti-ischemic therapy used in ACS?

A

Nitrates (sublingual or IV)

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15
Q

What can be used for secondary prevention in ACS?

A 
Statins
ACE inhibitors
Beta blockers
Smoking cessation 
Lifestyle modification
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16
Q

What are the definitions of unstable angina?

A

Angina at rest (>20 minutes)

New onset (<2 months) exertion angina

Recent acceleration of symptoms

Normal cardiac biomarkers (troponin)

17
Q

What is the definition of NSTEMI?

A

Absence of ST elevation on ECG but with angina symptoms and elevated cardiac biomarkers

18
Q

What other conditions may cause increased troponin?

A 
Pneumonia
PE
Pericarditis
Sepsis 
HF
19
Q

What is the management of UA/NSTEMI?

A 
Analgesia 
Anti-platelets
Anti-ischaemics
Statins
Angiography
20
Q

What blood vessels are used for coronary artery bypass?

A

Internal mammary artery or saphenous vein

T2: Theme 3: CVS (18 decks)

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