CAD and Vascular Disease Flashcards
(54 cards)
What is vasospastic angina?
Episodes of rest angina from vasospasm of coronary arteries that are relieved quickly by short acting nitrates.
Why do vasospasms of the coronary arteries cause chest pain?
Spasms cause the lumen of the vessel to become smaller, leading to ischemia and infarction if the spasms are persistent.
Risk factors for vasospastic angina.
Smoking, drugs, guide wire or balloon dilatation during PCI, botulism, magnesium deficiency, JAPANSESE DESCENT and age less than 50.
What are some differences between MI chest pain and vasospastic angina pain?
Described as discomfort rather than pain, gradual onset and stop.
Do you see EKG changes with vasospastic angina?
Yes, you can see transient elevation or depression in multiple leads.
How do you diagnose vasospastic angina?
Multiple episodes of angina type chest pain at rest and transient ST changes during an episode, without findings of coronary stenosis in coronary arteriography.
What is the first line treatment in preventing vasospastic angina?
Calcium channel blockers: nifedipine, diltiazem, verapamil, or amlodipine.
Work by preventing vasoconstriction and promoting vasodilation in coronary vasculature.
What medication can help terminate an episode of vasospastic angina?
Nitroglycerin
What medication can be added if a patient with vasospastic angina still need symptom control after using a CCB?
Long acting nitrates, such as isosobide mononitrate (Imdur)
T/F? There are no life threatening complications of vasospastic angina.
False, 25% of untreated patients can develop life threatening arrhythmia or MI. Treatment reduces life threatening events.
Stable angina is \_\_\_\_\_\_? A. Predictable and reproducible B. Relieved with rest C. Relieved with nitroglycerin D. All of the above
D. All of the above
What is one major difference between vasospastic angina and stable angina?
Vasospastic angina occurs at rest. Stable angina is relieved by rest.
What is a medication you would use in stable angina that is not indicated in vasospastic angina?
Beta blockers
CCB’s and nitrates are also used in stable angina.
When would angiography and revascularization be indicated in a stable angina patient who takes a CCB?
A. Significant interference in a patient’s lifestyle
B. Occurrence more than 2 times each week
C. It is never indicated for a stable angina patient
D. None of the above
D. None of the above
Angiography and revascularization is only indicated if symptoms interfere with a patient’s lifestyle despite maximal medical therapy
What is the difference between primary prevention and secondary prevention of an MI?
Primary is to prevent a first MI.
Secondary is to prevent another MI.
T/F. Aspirin is not used for primary prevention of MI’s.
True! No longer recommended for primary prevention.
What is the first line medical therapy for primary prevention of an MI?
Statin therapy if:
LDL >190
DM
40-75 years of age with sufficient ASCVD risk
What are secondary prevention options?
Treatment of risk factors ASA therapy High intensity stain beta block (after acute MI or HFrEF) ACEI/ARB especially in those with DM, CKD, HFrEF
Which of the following are true about PAD?
A. It is a disease of the venous system
B. It is most commonly from atherosclerosis
C. It a disease of the vascular system effects the coronary arteries
D. It is most commonly caused by emboli.
B. It is most commonly from atherosclerosis
Risk factors for PAD include all of the following except? A. Smoking B. Age > 65 C. Caucasian D. DM E. HTN D. Dyslipidemia
C. Caucasian
People of color are at higher risk of PAD
What are common symptoms of PAD?
Claudication, pain at rest, nonhealing wounds, ulceration, gangrene
What is the cause of blue toe syndrome?
Embolic occlusion of digital arteries with atheroembolic materiel from a proximal arterial source.
What is caudication?
Exertional leg pain
What is the likely area of disease for buttock and hip claudication?
Aortoilliac disease
