PATH - Ischemic Heart Disease Manifestations

Question 1

Stable Angina

Answer 1

usually with *ST depression

usually 2° to atherosclerosis

exertional chest pain in classic distribution, *resolving with rest or nitroglycerin.

Question 2

Unstable Angina

Answer 2

+/− ST depression and/or T-wave inversion

thrombosis with incomplete coronary artery occlusion

INC in frequency or intensity of chest pain or any chest pain at rest

Question 3

Variant (Prinzmetal) Angina

Answer 3

transient ST elevation

occurs at rest 2° to coronary artery spasm

Known triggers include tobacco, cocaine, and triptans, but trigger is often unknown.

Question 4

Coronary steal syndrome

Answer 4

Distal to coronary stenosis, vessels are maximally dilated at baseline.

Administration of vasodilators
(eg, dipyridamole, regadenoson) dilates normal vessels and shunts blood toward well-perfused areas–> DEC flow and ischemia in poststenotic region.

Principle behind pharmacologic stress tests.

Question 5

Chronic ischemic heart disease

Answer 5

Progressive onset of HF over many years due to chronic ischemic myocardial damage.