PowerPoint Chapter 15 Flashcards
What has been the leading cause of mortality in women since 1900?
Cardiovascular disease
CAD is not as common in women until the age of ____?
75
What are typical symptoms of CAD?
Typical symptoms: Chest painn, SOB, nausea, vomiting, sweating
What are atypical symptoms of CAD?
Atypical symptoms: indigestion, back pain, dizziness, fatigue, numbness
What are two types of angina from coronary obstruction?
Angina from Coronary obstruction like:
-Prinzmetal angina (coronary vasospasm)
-Microvascular angina (impaired endothelium that struggles to vasodilate)
What is Prinzmetal angina?
Coronary Vasospasm
-Narrowing (Vasoconstriction) of coronary vessels, causing ischemia or entire transmural response.
-Chest pain not related to /caused by atherosclerosis
Who is Prinzmetal Angina typically found in?
Typically in young females with a history of:
-Illicit drug use (Cocaine, Methamphetamines)
-Smoking
-Alcohol abuse
-Triptan use (Migraines or Reynaud’s)
-No CV risk factors
When does the chest pain for Prinzmetal angina occur?
Chest pain occurs at Night
ECG findings for Prinzmetal angina (how do they see it if it only occurs at night)?
ST Elevation
Reproduced by Acetylcholine
Reproduced by hyperventilation
Treatment for Prinzmetal angina?
Treatment
Calcium Channel Blockers or nitroglycerin to dilate blood vessels
What is microvascular angina caused by?
Caused by problems in smallest blood vessels of Coronary arteries struggling to vasodilate
What does microvascular angina lead to?
Leads to Myocardial Ischemia
What was microvascular angina previoulsy called?
Previously called Cardiac syndrome X
Who does microvascular angina typically affect?
Affects Women more than men
-Majority are postmenopausal
-More common in those with Diabetes, Hypertension, and smokers
When does microvascular angina occur?
Occurs at rest or exercise or stress
-Difficult to distinguish from classic angina
Signs and symptoms of microvascular angina (7)?
Chest pain – (heaviness, tightness, pressure or squeezing)
Sweating
Nausea
Dizziness
Stomach pain
Difficulty breathing
Fatigue
Treatments for microvascular angina?
Stop smoking
Eat healthy diet
Exercise
Weight management
Sleep and stress management
Treat other conditions like Hypertension and Diabetes
How is the prestentation of MI different for men rather than women (5)?
-Chest pain not as common
-Q Waves are more common in women than men
-Onset of symptoms is slower
-Often not requiring angiography’s or bypass surgeries
-Higher Mortality rate than men
(in-hospital and 6mo)
Exercise testing
-Exercise induced ____ ____ depression ____x more common in young healthy ____ than ____.
-Increase in ____ ____?
Exercise testing
-Exercise induced ST segment depression 4x more common in young healthy women than men.
-Increase in false positives?
What is the Duke treadmill test?
Duke Treadmill Test
-DTS = Exercise Time – (5x ST seg deviation) + (4x angina)
-0 = no angina, 1 = nonlimiting angina, 2 = limiting angina
-Score range: - 25(highest risk) to + 15 (Low risk)
What can improve the reliablity of testing in women ECGs?
ST/HR slope also improves reliability of testing
What are good questions to ask when thinking about evaluating women?
Do women reach adequate levels of stress during exercise to see ECG changes?
Should we explore other options like Stress imaging? Cardiac Cath? Pharmacological stress?
Describe Peripartum Cardiomyopathy?
Peripartum cardiomyopathy
-Development of LV dysfunction during pregnancy or within 5 months after delivery.
-No preexisting cardiac condition or diseases
-Present in 1 month post partum with symptoms of chronic heart failure
-No specific etiology
What are risk factors for peripartum cardiomyopathy?
Risk factors: maternal age, hx(history) of hypertension, multiple pregnancies, ethnically black background
ECG presentation of peripartum cardiomyopathy?
ECG shows LV dysfunction, Tachycardia and conduction disease. (LBBB)
What is Idiopathic Pulmonary Hypertension?
Arterial pressure in lung increases
What are symptoms of Idiopathic Pulmonary Hypertension?
Shortness of Breath (SOB)
Dizziness
RV hypertrophy
Heart failure
Idiopathic Pulmonary Hypertension is ____ more common in ____ than ____?
Idiopathic Pulmonary Hypertension is 3x more common in women than men
How does Idiopathic Pulmonary Hypertension appear on an ECG?
RV Hypertrophy
R axis Deviation
Tall R waves in V1
