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Cardiovascular > Session 10 > Flashcards

Session 10 Flashcards

1
Q

How can the lungs and pleura cause chest pain?

A

Pneumonia
Pulmonary embolism
Pneumothorax

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2
Q

How can the GI system cause chest pain?

A

Oesophagus reflux
Peptic ulcer disease
Cholecystitis

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3
Q

How can the chest wall cause chest pain?

A

Fractures to the ribs
Muscles
Skin

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4
Q

How can the CVS cause chest pain?

A

Myocardium - angina MI
Pericarditis
Aortic dissection

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5
Q

What are the non modifiable risk factors for coronary atheroma

A

Age
Sex (male worse)
Family history

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6
Q

What are the modifiable risk factors for coronary atheroma?

A 
Hyperlipidaemia
Smoking
Hypertension
Diabetes mellitus
Obesity
Exercise
Stress
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7
Q

How do you get ischaemia of the myocardium in stable angina?

A

Atheromatous plaques, with a necrotic centre and fibrous cap build up in the coronary vessels and partially occlude them

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8
Q

When do you get chest pain in stable angina?

A

Upon exercise
Cold
Stress

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9
Q

How can you treat angina?

A 
Nitrate sprays (Acute)
Beta blockers/Ca2+ channel blockers (prevent)
Aspirin, statins, ACEi (prevent cardiac episodes)
Revascularisation (long term)
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10
Q

What is unstable angina?

A

Pain on rest due to increased occlusion of the arteries

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11
Q

What is a myocardial infarction?

A

Complete occlusion of a coronary artery which leads to loss of oxygen and death of the myocardium

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12
Q

How can the atheromatous plaque cause an embolism to form?

A

The fibrous cap can undergo fissuring or erosion which exposes the blood to the thombogenic material in the necrotic core. A fibrin thrombus follows a platelet clot.

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13
Q

What is the difference between an NSTEMI and STEMI?

A

NSTEMI - Non elevated ST interval. Infarct is not full thickness of the myocardium
STEMI - Elevated ST interval. Infarct is full thickness of the myocardium

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14
Q

How can you diagnose angina?

A

Mainly based on the patient history
May have some of the associated risk factors
Exercise test - graded exercise until chest pain, target HR reached, ECG change, arrhythmia issues

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15
Q

What does an ECG positive for angina show?

A

An ST depression bigger than 1mm

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16
Q

What can cause Acute Coronary Syndrome?

A

Unstable angina
STEMI
NSTEMI

17
Q

How can you differentiate between unstable angina and a STEMI/NSTEMI?

A

T waves may be inverted in unstable angina

NSTEMI/STEMI would have Troponin in the blood as a biochemical marker

18
Q

Which leads would pick up on an infarct in the Right coronary artery? (inferior)

A

II, III, aVF

19
Q

Which leads would pick up on an infarct in the Left anterior descending? (Anterio septal)

A

V1, V2

20
Q

Which leads would pick up on an infarct in the distal section of left anterior descending? (antero apical)

A

V3, V4

21
Q

Which leads would pick up on an infarct in the circumflex artery? (antero lateral)

A

I, aVL, V5, V6

22
Q

Which leads would pick up on an infarct in the proximal left circumflex artery? (extensive anterior)

A

I, aVL, V2 - V6

23
Q

Which leads would pick up on an infarct in the right coronary artery? (true posterior)

A

Tall R wave in V1

24
Q

How are Troponins used to indicate a STEMI/NSTEMI?

A

Cardiac troponin I and troponin T are important in myosin and actin interaction. They are released on the muscle cells death

25
Q

What is the cardiac isoenzyme of creatinine kinase?

A

CK-MB

26
Q

How can CK-MB and Troponins in the blood help differentiate between unstable angina and NSTEMI?

A

Shows there has been death of the myocardium which only occurs in an NSTEMI

27
Q

What is the goal when treating unstable angina/MI?

A

Prevent progression to MI

Save muscle mass in an MI

28
Q

What can be given as part of anti thrombotic therapy?

A

Anti platelet agents - Aspirin

Anticoagulants - Heparin

29
Q

How can you restore perfusion to partially occluded vessels in high risk patients?

A

Early Percutaneous Coronary Intervention (Angioplasty) (PCI)

Coronary Artery Bypass Graft (CABG)

30
Q

How can you restore perfusion to partially occluded vessels in low risk patients?

A

Medications

31
Q

Why is Angiography useful?

A

Allows you to view any vessel occlusions, and from the findings can make decisions on revascularisation surgeries

32
Q

What is Percutaneous Coronary Intervention (PCI)?

A

Angiography with stenting

33
Q

What is stenting?

A

Inflation of a balloon inside the occluded vessel expands a mesh that holds the vessel open, increasing the lumen size and allowing for more blood to flow.

34
Q

What is Coronary By Pass Grafting (CBPG)?

A

Take an artery from elsewhere in the body and grafting it to the heart

35
Q

What arteries are commonly used in Coronary By Pass Grafting (CBPG)?

A

Radial artery

Saphenous vein BUT reversed because of the valves

Cardiovascular (15 decks)

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