management of coronary artery diseases Flashcards
1
Q
what are examples of stable ischemic heart disease
A
- chronic stable exertional angina
- ischemia without clinical symptoms
2
Q
what are examples of acute coronary syndrome
A
- unstable angina
- NSTEMI
- STEMI
3
Q
what are modifiable risk factors for CAD
A
- dyslipidaemia
- HTN
- DM
- smoking
- history of cerebrovascular or peripheral artery diseases
4
Q
what are non-modifiable risk factors for CAD
A
- age
- sex
- family history
4
Q
what are the signs and symptoms of angina
A
- diaphoresis
- nausea
- vomiting
- dyspnea
- tachycardia
- SOB
- light-headedness
5
Q
what is the therapeutic management of CAD
A
- balance O2 supply and demand
- manage pain
- MONA (morphine, oxygen, nitroglycerin, aspirin)
6
Q
what is the mechanism of action of GTN
A
- venous dilation to reduce preload
- reduces work needed on the heart
- reduces O2 demands
- coronary artery dilating increase O2+ flow to heart
7
Q
how does GTN work in relationship to collaterals
A
- allows collaterals to dilate
- blood can flow to ischemic areas
8
Q
how does GTN increase O2 supply and vasodilate
A
- GTN > nitrates > nitrites > NO
- absorbed into vascular smooth muscle cells
- monociliate enzymes activated
- GTP > cGMP
- relaxation and vasodilation
9
Q
what are the adverse effects of GTN
A
- headache
- palpitations
- postural hypotension
10
Q
what drug interactions does GTN have
A
PDE inhibitors - manage BPH and erectile dysfunction
11
Q
how can b-blockers be used in CAD
A
- block beta1 receptors in the heart
- decreasing HR and contraction
- decrease CO
- lowers O2 demand
12
Q
how does aspirin work
A
- antiplatelet
- opens the blocked arteries
- prevents reocclusion
13
Q
why are b-blockers contraindicated in prinzmetal angina
A
- increase coronary artery spasm
- causes chest pain
14
Q
what happens to O2 in atherosclerotic coronary stenosis
A
- imbalance in O2 demand and supply
- afterload and preload = stress on heart wall
