Chapter 11: Coronary Heart Disease

Question 1

What causes coronary heart disease?

Answer 1

Arteriosclerosis of coronary arteries

Question 2

Type of arteriosclerosis caused by accumulated lipid deposits (neutral fat & cholesterol) that diffused in from bloodstream; decreases blood supply to heart muscle.

Answer 2

Atherosclerosis

Question 3

What is the initiating event for atherosclerosis?

Answer 3

endothelial injury

Question 4

Plaque with necrotic core containing lipid (esp.

cholesterol which precipitates as crystals)

Answer 4

Atheroma

Question 5

True or false: Late stage atherosclerosis is reversible.

Answer 5

False; crystallized cholesterol and degenerative changes are irreversible.

Question 6

True or false: Initial stage atherosclerosis is reversible.

Answer 6

True

Question 7

Which stages of atherosclerosis are referred to as “hardening of the arteries.”

Answer 7

Late stages

Question 8

What are the 4 most important risk factors for atherosclerosis?

Answer 8

1) Elevated blood lipids, esp. LDL cholesterol*
2) High blood pressure
3) Cigarette smoking
4) Diabetes

Question 9

What is the most common cause of instant death?

Answer 9

Ischemic heart disease (coronary heart disease)

Question 10

Coronary heart disease

Answer 10

Ischemic heart disease

Question 11

Bouts of oppressive chest
pain that may radiate into neck or arms, caused by
myocardial ischemia

Answer 11

Angina pectoris

Question 12

Midsternal pain that occurs on exertion, subsides with rest, and is relieved by nitroglycerine tablet

Answer 12

stable angina

Question 13

Chest pain that occurs more
frequently than stable angina, lasts longer, and is less completely relieved by
rest or NG

Answer 13

unstable angina

Question 14

Chest pain that occurs at rest rather than

exertion, caused by coronary artery spasm

Answer 14

Prinzmetal’s angina

Question 15

What is the major type of coronary heart disease?

Answer 15

CAD

Question 16

Surgical procedure that bypasses obstructions in coronary arteries, usually employs segments of saphenous veins
(obtained from patient’s legs) or mammary/internal
thoracic arteries; only performed on pt’s with severe sclerosis of all 3 major coronary arteries.

Answer 16

Bypass surgery

Question 17

Procedure that uses a balloon catheter to smash plaque into the arterial wall, enlarging the lumen of the artery; typically followed by stent placement to keep the vessel open.

Answer 17

Coronary angioplasty

Question 18

What is the most dangerous stage of atherosclerosis?

Answer 18

Unstable plaques (atheroma) that can ulcerate and form a thrombus, which can occlude the vessel and result in a sudden MI

Question 19

What is the lifetime risk of CAD?

Answer 19

Women = 40%
Men = 50%

Question 20

How is CAD diagnosed?

Answer 20

Coronary angiogram (sometimes combined with CT)

Question 21

Possible treatments for CAD

Answer 21

1) Multiple drugs
2) Lifestyle changes (diet, quit smoking, weightloss, exercise, lower BP)
3) Surgery (coronary bypass or angioplasty)