3: Ischaemic heart disease & medical treatment

Question 1

Coronary heart disease is a common cause of ___ death.

Answer 1

premature

Question 2

50% of coronary heart disease deaths are ___.

Answer 2

sudden

Question 3

Worryingly, 2/3rds of sudden deaths are the (first/second/third) manifestation of coronary heart disease in individuals.

Answer 3

first

Question 4

What is an alternative name for coronary heart disease?

Answer 4

Ischaemic heart disease

Question 5

Sudden death in CHD can occur due to ___ which leads to cardiac arrest.

Answer 5

arrhythmia

Question 6

What is cardiac arrest?

Answer 6

Failure of the heart to pump blood around the body

Question 7

What is cardiogenic shock?

Answer 7

Inadequate systemic perfusion as a result of cardiac dysfunction

Question 8

Cardiogenic shock is a consequence of acute __ __.

Answer 8

myocardial infarction

Question 9

If acute coronary heart disease (e.g MI, arrythmia) is treated quickly, patients can go on to live a __ life with a __ quality of life.

Answer 9

long , good

Question 10

Coronary heart disease is much more common in (rural / industrial) areas.

Answer 10

industrial

Question 11

Name a common symptom of CHD.

Answer 11

Chest pain

Question 12

___ is a clinical diagnosis of chest pain.

Answer 12

Angina

Question 13

Even though tests can identify obstructive coronary lesions, ___ is the clinical diagnosis.

Answer 13

angina

Question 14

Which test are you likely to have if you present at a clinic with chest pain?

Answer 14

Coronary angiogram

Question 15

Why do patients get anginal chest pain?

Answer 15

Myocardial hypoxia

Question 16

Anginal chest pain is (difficult / easy) for patients to describe.

Answer 16

difficult

Question 17

Patients may use characteristic ___ to describe their angina to you.

Answer 17

gestures

Question 18

A patient experiences chest pain, while walking up a hill, which disappears after 30 seconds to a minute. What kind of pain is this?

Answer 18

Stable anginal chest pain

Question 19

If a patient’s chest pain does not go away after 2 minutes, what are the two possibilities?

Answer 19

1. They are having a heart attack
2. It’s not related to the heart

Question 20

What are some characteristics of anginal chest pain?

Answer 20

Pressing, squeezing, heaviness, a weight

Question 21

Where can anginal chest pain radiate?

Answer 21

Arms, back, neck, jaw, teeth

Question 22

What can anginal chest pain be associated with?

Answer 22

Exertion, stress, cold wind, after meals

Question 23

What may relieve anginal chest pain?

Answer 23

Rest, GTN spray

Question 24

Symptoms associated with chest pain may be coming from which other systems (see slides for more info)?

Answer 24

GI tract

Musculoskeletal

Other cardiovascular causes (pericarditis)

Respiratory (pleuritic chest pain)

Question 25

What is pericarditis?

Answer 25

Inflammation of the pericardium

Question 26

Name three acute emergency causes of chest pain.

Answer 26

**Myocardial infarction** (sense of impending doom, ongoing pain despite loads of morphine) **Pulmonary embolism** (breathlessness, dull) **Dissection of aorta** (tearing, excruciating, severe then eases)

Question 27

What is the cause of a tearing, excruciating pain associated with high blood pressure?

Answer 27

**Dissection** (of aorta)

Question 28

What type of pain is a clinical diagnosis of CHD?

Answer 28

**Angina** (chest pain)

Question 29

What are the advantages of using an exercise ECG to diagnose CHD?

Answer 29

**Cheap** **Reproducible**

Question 30

What investigation involves giving the patient a radioactive tracer and examining where it travels in heart tissue, based on blood supply?

Answer 30

**Perfusion scanning**

Question 31

What investigation involves giving the patient a radioactive tracer and using a CT scanner to examine their coronary arteries?

Answer 31

**CT angiography**

Question 32

What gold-standard investigation involves inserting a camera into arteries to identify CHD?

Answer 32

**Angiography**

Question 33

How is the risk of death reduced in someone with CHD?

Answer 33

**Drugs** **Lifestyle changes** **Revascularisation**

Question 34

What is the biggest lifestyle recommendation you can give to someone to reduce their risk of CHD?

Answer 34

**Stop smoking** | (Take exercise, eat a good diet)

Question 35

If someone presented with chest pain, what would you diagnose them with?

Answer 35

**Angina**

Question 36

Can someone have coronary disease without angina and vice versa?

Answer 36

Yes

Question 37

The presence of CHD can be suggested or confirmed by \_\_\_.

Answer 37

tests

Question 38

Which vessel is commonly occluded in an acute MI?

Answer 38

**Left anterior descending**