IHD

Question 1

Stable angina

Answer 1

Exertional chest pain
Relieve by tng or rest
Secondry to artheriosclerosis 
No necrosis
ST depression

Question 2

Prinzmetal (vasospastic) angina

Answer 2

Secondary to spasm coronary
Transient ST elevation
* HTN and HLP are not risk factors

Trigger: alcol o cocain
Tx: no smoking, CCB, nitrates

Question 3

Unstable angina

Answer 3

Thrombosis > incomplete occlusion
Unlike NSTEMI no cardiac marker elevation
With or wothout st depression and/or t inversion
At rest chest pain

Question 4

Sudden cardiac death

Answer 4

CAD
cardiomyopathy (dilated and hypertrophic)
Hereditary ion channelopathy (QT syndrome, Brugada)
Arrhythmia like VF
prevention : ICD

Question 5

STEMI

Answer 5

Transmural

Question 6

NSTEMI

Answer 6

Subendocardial

Question 7

MI complications 0-24 hrs

Answer 7

Coagulative necrosis
Edema
Hemorrhage
Wavy fibers
Reperfusion injury
Free radical generation
Lead to :
- ventricular arrhythmia 
-HF
-cardiogenic shick

Question 8

MI complications 1-3 days

Answer 8

Acute inflamation around necrosis
Extensive coagulative necrosis
Lead to :
-post infarction fibrinous pericarditis

Question 9

MI complication 3-14 days

Answer 9

Macrophage
Granulation tissue at margins
Lead to 
-free wall rupture and tamponade
-papillary rupture and MR
-interventricular septal rupture 
-LV pseudo aneurysm

Question 10

MI complication 2w to several months

Answer 10

Dressler syndrome
HF
Arhythmia
Ventricular aneurysm (risk of mural thrombus)
Contracted scar

Question 11

STEMI Tx

Answer 11

Reperfusion therapy (percutaneous intervention prefered over fibrinolysis) 
\+ NSTEMI tx

Question 12

NSTEMI

Answer 12

For pain (morphin tng) 
Statin
Betablocker 
Ace inhibitor
Anticoagulation (heparin) 
Anti platelets (aspirin
ADP receptor inhibitor (clopidogrel)