Treating Coronary Artery Disease

Question 1

What is the first SIGN of an atherosclerotic plaque?

Answer 1

Angina pectoris

Question 2

What is angina pectoris?

Answer 2

Chest pain

Question 3

What is the physiological background of angina pectoris?

Answer 3

When metabolic demands of a region of myocardium exceed the ability of blood supply to satisfy those needs because blood flow is compromised.

Question 4

Angina pectoris can often be seen with changes on what recording device?

Answer 4

Electrocardiogram

Question 5

What are 4 tests to confirm angina pectoris?

Answer 5

1. Gastroesophogeal reflux
2. Hyperventilation
3. Costochondritis
4. Exercise test
   All in conjunction with an ECG, thallium scan, and looking for signs of pain

Question 6

What is silent ischemia?

Answer 6

Coronary artery disease that does not show pain

Question 7

What are 3 medications to treat angina?

Answer 7

1. Nitrates
2. Beta blockers
3. Calcium channel blockers

Question 8

What do nitrates do in treating angina?

Answer 8

1. Dilate peripheral veins and arteries
2. Reduce venous return and blood pressure
3. Reduce heart preload and afterload
4. Increase blood flow to the coronary artery causing pain

Question 9

What do beta blockers do in treating angina?

Answer 9

Prevent the sympathetic nervous system from stimulating myocardial beta-1 receptors. This reduces heart rate, contractility, and metabolic demand.

Question 10

What do calcium channel blockers do in treating angina?

Answer 10

Lessen the contractility of the cardiac and smooth muscle, reducing metabolic demands.

Question 11

What option is available for patients with angina who cannot be treated with common medications?

Answer 11

Mechanical revascularization

Question 12

What are 2 types of mechanical revascularization?

Answer 12

1. Coronary artery bypass grafting

2. Percutaneous transluminal coronary angioplasty

Question 13

A percutaneous transluminal coronary angioplasty is always done simultaneously with a?

Answer 13

Coronary artery catherization

Question 14

What is done during a percutaneous transluminal coronary angioplasty? 5 steps.

Answer 14

Catheter pathway:

1. Into left ventricle
2. Out of left ventricle
3. Into aorta
4. Into coronary artery
5. Inflate balloon to flatten plaque and restore blood flow

Question 15

What is the cause of proliferation of a plaque at the same location after angioplasty?

Answer 15

VSMCs