2.8.2013 Flashcards

0
Q

Adverse prognostic factors in stable ischemic heart disease

A
H/O previous MI
recent episode of unstable angina/new onset angina
EF<50%
HT,DM,dyslipidemia
Increasing age
Family h/o CAD
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1
Q

FFR

A

Fractional flow reserve

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2
Q

________ is a powerful predictor of short and longterm course of SIHD

A

LV function

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3
Q

Intermediate and high risk groups in SIHD based on EF

A

Intermediate- 35 to 49%

High - less than 35%

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4
Q

Maximum anti ischemia therapy

A

Atleast two classes were used

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5
Q

Which is preferred for restenosis after CABG?

repeat CABG or PCI

A

PCI

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6
Q

Hybrid coronary revascularisation

A

LIMA for LAD

PCI of other stenosed coronary arteries

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7
Q

Role of dual anti platelet therapy in chronic stable angina

A

No role

Clopidogrel is given only for aspirin allergic pts

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8
Q

Nicorandil is useful for

A

Microvascular angina

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9
Q

BP control in SIHD

A

Less than 140/90
Less than 130/80 in diabetics and CKD pts
Aggressive control(120/80) in young pts and hypertensives of short duration

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10
Q

Effect of PUFA on cholesterol

A

Decreases both LDL and HDL

MUFA doesnot reduce HDL

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11
Q

Lipid therapy in SIHD

A
High risk(risk factors or CAD equivalents are present)
LDL less than 100
Non HDL C less than 130
Very high risk(ACS or established CAD)
LDL less than 70
Non HDL C less than 100
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12
Q

Goal HbA1C in SIHD

A

Less than 7%

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13
Q

Role of ACE inhibitors in SIHD

A

EF less than 40%
CKD
DM

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14
Q

Rx of refractory angina

A

Enhanced external counterpulsation

Spinal cord stimulation

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15
Q

Mechanism of enghanced external counterpulsation

A

Similar to IABP

16
Q

Conduits used in CABG

A
Saphenous vein 
Internal thoracic artery
Radial artery
Rt gastroepiploic artery
Inferior epigastric artery
Cryo preserved homograft veins
17
Q

Which is the best bypass conduit?

A

LIMA

18
Q

Why LIMA is best bypass conduit?

A

Endothelium produces EDRF and prostacyclin

Tight internal elastic lamina

19
Q

How ischemia of myocardium during bypass is prevented?

A

Infusion of k+ rich solution which arrests heart in diastole

20
Q

Complications of CABG

A

1.Neurological dysfunction
Renal dysfunction
SIRS

21
Q

Indications for CABG

A

Left main stenosis
Non LMS
TRIPLE vessel disease with more than 70% stenosis
Proximal LAD + 1 major coronary vessel

22
Q

RIMA is used in

A

Dextrocardia

23
Q

Pump head syndrome

A

Neurocognitive deficits after On pump CABG

24
Q

Role of folates in SIHD

A

No role(though they were thought to play a role by reducing homocysteine level)