PowerPoint Chapter 15

Question 1

What has been the leading cause of mortality in women since 1900?

Answer 1

Cardiovascular disease

Question 2

CAD is not as common in women until the age of ____?

Answer 2

75

Question 3

What are typical symptoms of CAD?

Answer 3

Typical symptoms: Chest painn, SOB, nausea, vomiting, sweating

Question 4

What are atypical symptoms of CAD?

Answer 4

Atypical symptoms: indigestion, back pain, dizziness, fatigue, numbness

Question 5

What are two types of angina from coronary obstruction?

Answer 5

Angina from Coronary obstruction like:
-Prinzmetal angina (coronary vasospasm)
-Microvascular angina (impaired endothelium that struggles to vasodilate)

Question 6

What is Prinzmetal angina?

Answer 6

Coronary Vasospasm
-Narrowing (Vasoconstriction) of coronary vessels, causing ischemia or entire transmural response.
-Chest pain not related to /caused by atherosclerosis

Question 7

Who is Prinzmetal Angina typically found in?

Answer 7

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

Question 8

When does the chest pain for Prinzmetal angina occur?

Answer 8

Chest pain occurs at Night

Question 9

ECG findings for Prinzmetal angina (how do they see it if it only occurs at night)?

Answer 9

ST Elevation
Reproduced by Acetylcholine
Reproduced by hyperventilation

Question 10

Treatment for Prinzmetal angina?

Answer 10

Treatment
Calcium Channel Blockers or nitroglycerin to dilate blood vessels

Question 11

What is microvascular angina caused by?

Answer 11

Caused by problems in smallest blood vessels of Coronary arteries struggling to vasodilate

Question 12

What does microvascular angina lead to?

Answer 12

Leads to Myocardial Ischemia

Question 13

What was microvascular angina previoulsy called?

Answer 13

Previously called Cardiac syndrome X

Question 14

Who does microvascular angina typically affect?

Answer 14

Affects Women more than men
-Majority are postmenopausal
-More common in those with Diabetes, Hypertension, and smokers

Question 15

When does microvascular angina occur?

Answer 15

Occurs at rest or exercise or stress
-Difficult to distinguish from classic angina

Question 16

Signs and symptoms of microvascular angina (7)?

Answer 16

Chest pain – (heaviness, tightness, pressure or squeezing)
Sweating
Nausea
Dizziness
Stomach pain
Difficulty breathing
Fatigue

Question 17

Treatments for microvascular angina?

Answer 17

Stop smoking
Eat healthy diet
Exercise
Weight management
Sleep and stress management
Treat other conditions like Hypertension and Diabetes

Question 18

How is the prestentation of MI different for men rather than women (5)?

Answer 18

-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)

Question 19

Exercise testing
-Exercise induced ____ ____ depression ____x more common in young healthy ____ than ____.
-Increase in ____ ____?

Answer 19

Exercise testing
-Exercise induced ST segment depression 4x more common in young healthy women than men.
-Increase in false positives?

Question 20

What is the Duke treadmill test?

Answer 20

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)

Question 21

What can improve the reliablity of testing in women ECGs?

Answer 21

ST/HR slope also improves reliability of testing

Question 22

What are good questions to ask when thinking about evaluating women?

Answer 22

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?

Question 23

Describe Peripartum Cardiomyopathy?

Answer 23

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

Question 24

What are risk factors for peripartum cardiomyopathy?

Answer 24

Risk factors: maternal age, hx(history) of hypertension, multiple pregnancies, ethnically black background

Question 25

ECG presentation of peripartum cardiomyopathy?

Answer 25

ECG shows LV dysfunction, Tachycardia and conduction disease. (LBBB)

Question 26

What is Idiopathic Pulmonary Hypertension?

Answer 26

Arterial pressure in lung increases

Question 27

What are symptoms of Idiopathic Pulmonary Hypertension?

Answer 27

Shortness of Breath (SOB)
Dizziness
RV hypertrophy
Heart failure

Question 28

Idiopathic Pulmonary Hypertension is ____ more common in ____ than ____?

Answer 28

Idiopathic Pulmonary Hypertension is 3x more common in women than men

Question 29

How does Idiopathic Pulmonary Hypertension appear on an ECG?

Answer 29

RV Hypertrophy
R axis Deviation
Tall R waves in V1