S2 L2.4: Symptoms and Degree of Vessel Stenosis

Question 1

T/F

One may predict the level or severity of stenosis based on the lesion and physical activity

Answer 1

True

Question 2

Match the following:

1. Blood flow at rest may be reduced
2. Anginal on strenuous exertion
3. A limitation on the ability to increase flow to meet increased myocardial demand
4. Angina at rest or on mild exertion
5. Further minor decreases in the stenotic orifice area can reduce coronary flow dramatically and cause myocardial ischemia
6. There’s anginal on strenuous exertion class 1
   functional classification under Canadian
   Classification

A. 50% stenosis of an epicardial artery
B. ~80% stenosis of an epicardial artery

Answer 2

1. B
2. A
3. A
4. B
5. B
6. A

Question 3

T/F
1. Anything in between Class 1 and Class 4 (Class
2,3) may mean 60-70% stenosis
2. Class 2 may mean 60% stenosis under
Canadian Classification; Class 2 must be
very careful when conducting therapy
sessions → dealt with angioplasty, bypass
3. Class 1 = allowed to do intense
activities such as burpees
4. Mostly if patient experiences pain during
exercise patients even if it’s just mild, it
might be Class 3.
5. PT interventions can be safely done in Class 3

Answer 3

1. T
2. T
3. F. Class 1 - you already do not do intense
   activities such as burpees
4. T
5. F. Mostly if patient experiences pain during
   exercise patients even if it’s just mild, it
   might be Class 3 → report to physician right
   away that patient is experiencing pain in
   normal ADLs

Question 4

T/F

The major risk factors for vessel stenosis are almost the same as the ones with hypertension

Answer 4

True

Question 5

Give me at least four (4) major risk factors of vessel stenosis

Answer 5

Advancing age
Male sex
Tobacco smoking
Diabetes mellitus
Dyslipidemia
Hypertension

Question 6

T/F

1. Testosterone does not predispose an individual to develop CAD
2. Transgender who take testosterone shots (female to male) are at a higher risk
3. Diabetes patients = CAD equivalents
4. Diabetic mellitus is a metabolic syndrome
5. Dyslipidemia means ↑Total Cholesterol and LDL, ↓HDL*, and ↑Triglycerides

Answer 6

1. F. Testosterone predisposes an individual to develop CAD
2. T
3. T
4. T
5. T

*HDL is the one that cleanses LDL out of the system; good cholesterol

Question 7

What are the other risk factors of vessel stenosis?

Answer 7

Abdominal obesoty
Ethnic characteristics
Family history of CAD
Obesity
Physical inactivity
Psychocsocial factors

Question 8

OTHER RISK FACTORS OF VESSEL STENOSIS

More than trunk obesity, this is more important

Answer 8

Abdominal obesity

Asian men must have 32 or less waist size; for Asian women, it must be significantly less

Question 9

OTHER RISK FACTORS OF VESSEL STENOSIS

Ex. too much carbohydrates, Adobo, too much salt in the Filipino culture

Answer 9

Ethnic characteristics

Question 10

OTHER RISK FACTORS OF VESSEL STENOSIS

More so if one individual had an heart attack before the age of 50, which is called precocious heart attack

Answer 10

Family history of CAD

Question 11

What is a precocious heart attack?

Answer 11

If one individual had an heart attack before the age of 50, it is called precocious heart attack

Question 12

What are the novel risk factors of vessel stenosis?

Answer 12

(We can stratify the risks if we ask for some lab results)
● HSCRP*
● Homocysteine
● Fibrinogen and fibrin D Dimer
● Lipoprotein A
● Small LDL particles

*High-sensitivity C-reactive protein (hsCRP) is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals (source: google)

Kindly check the graph in the transes for this for more infooo ;>

Question 13

Match the following items:
1.HSCRP
2. Dyslipidemia
3. Hypertension
4. Homocysteine
5. Small LDL particles

A. Novel risk factors
B. Major risk factors
C. Other risk factors

Answer 13

1. A
2. B
3. B
4. A
5. A

Question 14

Match the following items:
1. Advancing age
2. Male sex
3. Tobacco smoking
4. Fibrinogen and fibrin D Dimer
5. Lipoprotein A
6. Small LDL particles

A. Novel risk factors
B. Major risk factors
C. Other risk factors

Answer 14

1. B
2. B
3. B
4. A
5. A
6. A

Question 15

Match the following items:

1. Obesity
2. Abdominal obesity
3. Ethnic characteristics
4. Diabetes mellitys
5. Physical inactivity
6. Psychosocial factors

A. Novel risk factors
B. Major risk factors
C. Other risk factors

Answer 15

1. C
2. C
3. C
4. B
5. C
6. C