CAD Flashcards
S2Q2
CAD: Intro
other name, pathology, which side die more, main etiology + example
trend killer + 1>1>1
risks (5)
ischemic heart disease
- narrowing of epicardial arteries
- L die more in circulation
- d/t atherosclerosis (reuse oil)
- CVD as #1 killer
- ischemic heart disease > stroke > cardiovascular
risks
- diet, smoking, alcohol, sedentary, pollution
CAD: Angina
other name, etiology (3)
sx - what, where (3), radiate (4)
stable angina - sx duration + otherwise
- chest pain
- deep visceral squeezing pain on substernal, back, epigastric
- radiate to: jaw, neck, shoulder, arm
- eti: exertion, emotional upset, anything that inc demand on myocardium
STABLE ANGINA
- transient, 2-30 mins
- if >30 mins = heart attack
CAD: Angina
likely - age, (5)
- > 65y
- DM
- faintness
- fatigue
- eructation (empacho; GI)
- epigastric pain (sinisikmura; don’t just give antacids)
CAD: Angina
fixed threshold - (2)
variable - 1st thing when, 2nd thing (1=1)
mixed - what
fixed threshold
- constant level of activity
- pt can predict at what level will cause
variable threshold
- circadian: usually AM, inc catecholamine during sleep = inc HR BP when wake up
- postprandial = more carbohydrates = splanchnic steal blood from heart
- has good & bad days
mixed threshold
- can’t be defined
CAD: Angina
unlikely - (5)
pleuritic pain
- sharp/knife pain in inhalation & exhalation
- can pinpoint
pain primarily in middle/lower abdomen
reproduced when press chest or movement
last few secs or longer
CAD: Angina
class 1-4 new york vs. canada
which treatable
CLASS I
CLASS II
- new york: slight limit in physical activity
- canada: slight limit in ordinary
CLASS III
- new york: slight limit in ordinary
- canada: marked limit
- walk 1-2 blocks
CLASS IV
- can’t carry out d/t sx even at rest
- don’t treat class 3-4
- ADL limits: class III & II
CAD: Atherosclerosis
pathology (2 + where = 1 = 1)
if inc plaque then what happens (2.1)
stable (1) vs. unstable (1=1=1)
- LDL (cholesterol plaques) & monocytes get stored in endothelium of intima = clot = obstruct lumen
- inc plaque = arterial wall thicken & harden, smooth muscle multiply
- stable: won’t easily rupture
- unstable: rupture = wound that bleeds = clot
CAD: Atherosclerosis
timeline - (2.2.2)
— FFIAFL
1st decade
foam cells
fatty streak
2nd decade
intermediate lesion
atheroma
3rd decade
fibrous plaques
lesion
CAD: Atherosclerosis
main triggers (2) - what, what + example
hemodynamic
- sudden inc/dec
prothrombotic
- drugs that cause blood viscosity
- contraceptive pills
CAD: Atherosclerosis
ischemic triggers - (4), pulse pressure what + normal, HR normal, extra (2)
- exercise
- cold exposure
- upright
- smoking
- catecholamine, platelet activation
pulse pressure
- difference between SBP & DBP
- N: 40
HR
- N: 50-70
CAD: Non-Atherosclerotic Cause
(5)
myocardial bridging - normal location (2), what happens (1) (1=1), tx
aortic dissection - etiology, sx, tx
- congenital anomaly, granuloma, tumor, scar from trauma, radiation from cancer tx
myocardial bridging
- coronary artery should be epicardial (on top of heart & outside epicaridum)
- cross bridging
- embed into muscle = impingement
- tx: nothing
aortic dissection
- high BP = torn = chest pain = emergency or death
CAD: Non-Atherosclerotic Cause
transient (3) - associated + sx, where, where
vasospasm
- raynaud’s phenomenon
- episodic
embolus
- elsewhere
thrombus
- heart/same origin
CAD: Non-Atherosclerotic Cause
degree (2) - sx
exercise x vessel
50% stenosis of epicardial artery
- angina in strenuous
80% stenosis
- angina at rest
exercise can form new blood vessels but long time
CAD: Risk Factors
sex + why, race, 3 conditions
family Hx death age
psych - trend, (2)
sex
- male d/t testosterone
- female protected by progesterone & estrogen til menopause
race
- black, southeast asian
- DM: walking time bomb
- dyslipidemia: high LDL
- abdominal obesity: DM
- family Hx of CAD: genetic, die by 50y
- psych: leading cause d/t stress & depression
CAD: Syndromes
chronic stable angina - etiology, hx, prognosis
- eti: atherosclerotic plaque
- existed before, progressive
