Session. 9.1

Question 1

What are the symptoms of cardiac ischaemia?

Answer 1

Visceral pain

• dull, poorly localised
• worsened with exertion

Question 2

What are the symptoms,of pleuritic chest pain?

Answer 2

Somatic pain - on phrenic nerve

• sharp pain, often well localised
• worsened with inspiration, coughing or positional movement

Question 3

What are the causes of cardiac chest pain?

Answer 3

Non ischaemic e.g pericarditis

Ischaemic and infarction

Question 4

What are the non cardiac causes of chest pain?

Answer 4

Respiratory e.g pneumonia
Gastro intestinal e.g reflux
MSK
Aortic dissection

Question 5

What’s pericarditis?

Answer 5

Inflammation of the pericardium
Often secondary to viral illness
Presents with chest pain
- retrosternal
- sharp pain, localised to front of chest
- aggravated with inspiration, cough, lying flat
- eased with sitting up and leaning forward
- pericardial rub may be heard on auscultation

May be widespread ST elevation in all leads

Question 6

What are some risk factors for atherosclerosis (/ischaemic heart disease)?

Answer 6

Smoking
Hypertension 
Diabetes
Old age 
Male
Obesity

Question 7

When does heart tissue ischaemia occour?

Answer 7

When metabolic demands of cardiac muscle are greater than what can be delivered via coronary arteries e.g on exertion

Question 8

What does acute coronary syndrome include?

Answer 8

Stable angina
Unstablee angina
MI 
NSTEMI
STEMI

Question 9

What’s an acute coronary syndrome?

Answer 9

A spectrum of increasing occlusion from an acute plaque rupture
Cause acute myocardial ischaemia

Question 10

What are the Features of unstable angina?

Answer 10

Pain at rest
Pain may be More intense
Pain may last longer
Risk Of deteriorating further = NSTEMI/STEMI

Question 11

How will someone with an acute coronary syndrome appear?

Answer 11

Sweaty, anxious, pale

Question 12

What diagnostic tests are done in someone with a suspected acute coronary syndrome?

Answer 12

ECG
- changes suggestive of current ischaemia or infarct

Blood test
- troponin

Question 13

What is stable angina???

Answer 13

Ischaemic pain which is experienced during exertion and resolves with rest. occurs when metabolic demands of the cardiac tissue exceed the delivery of oxygen by coronary arteries

Question 14

What causes the acute event in ACS?

Answer 14

Rupture of an atheromatous plaque and thrombus formation.