Angina

Question 1

Angina Pectoris

Answer 1

severe chest pain originating from heart in response to an inadequate O2 supply to myocardial cells compared to demand

ie. ischemia

Question 2

precipitating conditions of angina

Answer 2

hyperthyroidism
hypertension
↑physical activity
emotional stress
exposure to cold

Question 3

anginal pain

Answer 3

experienced as recurrent, intermittent brief episodes of substernal pain that may radiate to neck and left arm

if myocardial dysfunction occurs, dyspnea may develop

Question 4

what is anginal pain described as

Answer 4

pressure, squeezing, aching or suffocating

Question 5

what is anginal pain manifested as in ECG

Answer 5

ST segment depression

Question 6

stable anginal

Answer 6

type of chronic ischemic heart disease associated w/ a stable, fixed obstruction, usually atherosclerotic

Question 7

stable anginal is precipitated by

Answer 7

↑physical activity
emotional stress
exposure to cold

Question 8

how long does stable anginal pain last?

Answer 8

usually short-lived (<5mins)

Question 9

how is stable anginal pain relieved?

Answer 9

w/ rest (↓O2 demand) or administration of nitroglycerin or nitrates

Question 10

what does it mean if stable anginal pain does not subside?

Answer 10

if pain does not subside within 10mins of rest, pain may be d/t severe ischemia

Question 11

unstable angina occurs with what kind of pts?

Answer 11

individuals w/ worsening CAD - type of acute coronary syndrome

Question 12

what happens in unstable angina when atherosclerotic plaque ruptures?

Answer 12

stimulates thrombus formation and vasospasm => more severe, acute ischemia - can progress to MI

Question 13

what kind of atherosclerotic plaque is believed to involve unstable angina?

Answer 13

atherosclerotic plaques that contain small amounts of fibrous protein and more lipid which predisposes them to rupture

Question 14

what are unstable angina episodes like?

Answer 14

unpredictable and occur w/o exercise, during sleep or at total rest

Question 15

unstable angina manifestations

Answer 15

pain similar to stable angina - but lasting up to 20mins

not relieved by rest or nitroglycerin

Question 16

unstable angina with brief myocardial ischemia

Answer 16

if resulting myocardial ischemia is brief, ventricular dysfunction is completely reversible

Question 17

unstable angina with persiting myocardial ischemia

Answer 17

if ischemia persists for less than 30mins, ventricle may become “stunned” and have decreased function that can last for weeks

Question 18

what happens if blood flow is not restored in unstable angina?

Answer 18

if blood flow is not restored within 40-60mins, infarction happens => permanent myocardial dysfunction

Question 19

following unstable angina is a risk to what?

Answer 19

↑risk of MI

Question 20

treatment of unstable angina

Answer 20

aspirin
anticoagulants