Lectures 1-6 Cardiovascular Flashcards
what are the 3 things listed under acute coronary syndromes
-unstable angina
- non ST segment elevation MI
- ST segment elevation MI
describe primary prevention
no current disease, preventing the first event from happening
what is another word for prinzmetal angina
vasospastic disease
what are the 3 types of angina
Printzmetals variant
chronic stable
unstable
of the 3 types of angina, which is considered “demand ischemia”
chronic stable
“fixed stenosis” in other words
chronic stable angina
“vasospasm” in other words
Printzmetal’s variant angina
“thrombus” in other words
unstable angina
angina has what effect on coronary blood flood
decrease
an increase in HR contractility, afterload, and preload has what effect on oxygen consumption
raises it
a decrease in contractility has what effect on O2 consumption?
lowers it, moving less=less need for O2
Preload-LVEDV:
- ______ed by venodilation
- _______se leads to ______ in O2 consumption
- ______ leads to increase in myocardial perfusion (things being able to pass through)
decreased, decrease, decrease
Afterload:
- Decreased by _______ of arteries
- decrease leads to decrease in ___ _______
dilation, O2 consumption
what is stable angina pectoris usually associated with?
large single to multi vessel ASCAD
what are the 4 main epicardial vessels?
Right coronary artery
Left main
Left anterior descending
Left circumflex
Ischemia is NOT associated with what? ( from slides i know this can be a million things)
myocardial necrosis
whats that pneumonic we talked about regarding clinical presentation?
PQRST
Precipitating Factors
Palliative measures
Quality and quantity of pain
Region and Radiation
Severity of the pain
Timing and temporal pattern
Typical angina:
- _________
- duration: ____-____ min
- NTG/______ _____
substernal
0.5-20 min
rest reilef
What are the normal ECG findings of a typical angina?
ST-segment depression (during an event)
what is the most common procedure done in the US that is considered a “definitive assessment of coronary anatomy”?
Cardiac Catheterization and coronary angiography
where is the most common site for cardiac catherization?
radial artery in wrist
Each of the following statements regarding chronic coronary
disease is correct EXCEPT?
A. Stable angina is associated with pain that is increasing in
severity and not relieved by NTG
B. Women and patients with diabetes may experience atypical
symptoms
C. Angina is discomfort associated with ischemia
D. Prinzmetal’s or variant angina is associated with coronary
vasospasm
E. Chronic coronary disease is usually associated with
atherosclerosis
A
give the treatment goals for the following risk factors:
Dyslipidemia:
htn:
Diabetes (A1C):
> 50% reduction in LDL
BP <130/80
A1C < 7%
T or F: Low does aspirin decreases platelet aggregation
True
what is the loading dose of aspirin?
162-325 mg (more often 325)
Mechanism of aspirin (low dose)
irreversibly inhibit COX-1, blocking the formation of TXA2-> preventing platelet aggregation
clopidogrel loading dose
300-600 mg
Mechanism of aspirin (high dose)
inhibits COX-2, blocking formation of PGI2
Prasugrel loading dose
60 mg
ticagrelor loading dose
180 mg
normal dose aspirin
75-162 mg
normal dose clopidogrel
75 mg daily
normal dose prasugrel
10 mg daily
normal dose ticagrelor
90 mg BID
normal dose Cangrelor
this is a trick, its IV only
-
-
gastrointestinal bleeding
hematologic bleeding (intra and extracranial)
hypersensitivity
T or F: Clopidogrel and Prasugrel require activation
True, they are both prodrugs
T or F: in order to have the same effect as clopidogrel, you need a larger amount of prasugrel
false, you need more clopidogrel
which P2Y12 inhibitor is more CYP dependent?
Clopidogrel
-
bleeding, diarrhea, rash
~1% increase in major bleeding when added to ASA
-
bleeding, diarrhea, rash
~-0.6% increase in major bleeding compared to clopidogrel
Adverse effects Ticagrelor
bleeding, bradycardia, heart block, dyspnea ss
