stable angina and diagnostics Flashcards
What is ischemia
Imbalance between oxygen supply and demand
What is the most common cause of atherosclerotic disease of coronary arteries
Ischemic heart disease
What is stable angina
Episodic clinical syndrome due to transient myocardial ischemia
How is CK beneficial when working up an MI
Quantifies the timing and degree
Rises 4-6 hours post MI
Baseline in 36-48 hours
What lab is more sensitive and specific than CK in regards to MIs
Troponin
What can troponin levels help diagnose
ACS
Risk stratify unstable angina
Why are serial cardiac troponin labs taken post MI
To distinguish between acute / chronic injury and MI
How do you distinguish between myocardial injury and myocardial infarction
evidence of ischemia
When is LDH elevated
with lack of oxygen
Which type of patients is LDH used more commonly on
shock / critically ill patients
What does CRP help with
helps predict mortality
What is increased CRP associated with
Atherosclerosis
CV events
Recurrent CV events
Where in the heart is BNP released from
ventricles
What does BNP measure
LV stress
*good marker for HF
What is a good BNP negative predictive value in CHF
<100
What is Doppler helpful with on US
Quantify the velocity of blood flow
valve gradiants
valve disease
When is a TEE more useful than a TTE
Aortic dissection
thrombus
vegetations
posterior structures
What is measured in the heart during stress testing
Chronotropic incompetence
What drugs can be used for a stress test when a patient is immobile
dobutamine
Dipyramidole
What test is the gold standard for atherosclerosis
Angiograms
What is a type 1 MI
acute plaque rupture leads to ischemia and necrosis
What is a type 2 MI
supply and demand mismatch
What is a type 3 MI
Sudden cardiac death
What is a type 4 MI
Procedure related, stent thrombosis
What is a type 5 MI
s/p CABG
Which drug classes are best for ACS
Morphine
O2
Nitro
Aspirin
ACEi
What anti-anginals are used with stable angina
beta blockers
calcium blockers (except nifedipine)
nitrates
What type of medication give survival benefit post MI
Statin