SIHD background Flashcards
sowsinski pgs 1-38
what conditions make up chronic coronary disease?
stable angina/stable ischemic heart disease (SIHD)
post-ACS or revascularization
angina with coronary artery spasm/microvascular angina
what conditions make up acute coronary syndrome (ACS)?
unstable angina
NTSEMI
STEMI
what is the leading cause of death in both men and women?
atherosclerotic CAD
1 in every 3 deaths in the US
how does ASCAD risk correlate to age and gender?
increases with age
greater in men than women until menopause
what demographic is most effected by ASCAD?
black people - 150M, 82F
white - 130M, 66F
hispanic - 95M, 51F
how much is the direct and indirect costs of CVD?
422B dollars
what are the three types of angina?
printzemtal’s variant angina
chronic stable angina
unstable angina thrombus
what are the characteristics of printzmetal’s variant agina?
vasospasm causes the big artery to close causing supply ischemia
what is the characteristics of chronic stable angina?
cholesterol plaque builds up in a fixed stenosis that prevents blood flow causing a demand ischemia
what are the characteristics of unstable angina?
a thrombus forms causing a supply ischemia
what are the factors of O2 supply?
coronary blood flow
O2 carrying capacity
what are the factors of O2 demand?
wall tension –> LV volume (preload) and systolic pressure (afterload)
contractility
heart rate
what makes up wall tension?
LV volume aka preload
systolic pressure aka afterload
how does contractility affect myocardial O2 S/D?
a decrease in contractility will see a decrease in O2 consumption
how does heart rate affect myocardial O2 S/D?
decreased HR will decrease O2 consumption
decrease HR will increase coronary perfusion
how does preload (LV volume) affect myocardial O2 S/D?
decrease leads to decrease in O2 consumption
decrease leads to increase in myocardial perfusion
how does venodilation affect pre-load?
the widening of veins leads to a decrease in preload
how does afterload affect myocardial S/D?
decrease leads to decrease in O2 consumption
how does dilation affect afterload?
dilation of arteries leads to a decrease in afterload
what are the two factors that lead to ischemia?
decrease coronary blood flow
increased oxygen consumption
what is stable angina pectoris associated with?
large single to multi vessel ASCAD
what is the definition of angina?
resulting symptoms from ischemia
a clinical syndrome of chest discomfort
what is the clinical presentation of angina?
Precipitating factors
Palliative measures
quality and quantity of pain
region and radiation
severity of the pain
timing and temporal pattern
where should angina pain be located?
substernal
may travel to left arm or left jaw
