CHD FoCP 1 Flashcards Preview

Coronary Heart Disease > CHD FoCP 1 > Flashcards

Flashcards in CHD FoCP 1 Deck (18):
1

What is the order of disease progression in coronary heart disease?

Normal --> Fatty streak --> Plaque --> Obstructive atherosclerotic plaque(and exertional angina) --> Plaque fissure or erosion leading to thrombosis --> Unstable angina/acute MI/death

2

Define stable angina

Predictable, not worsening, usually exertional

3

Define unstable angina

sudden deterioration, with pain coming on at rest/waking from sleep. no cardiac enzyme release

4

Define NSTEMI

MI with no ST elevation. release of cardiac enzymes.

5

Cause of stable angina

Fixed stenosis in artery due to atheromatous plaque

6

Cause of acute coronary syndromes

plaque rupture/fissuring leading to platelet activation and in/complete coronary occlusion

7

Stable angina

Increase in demand of myocardial tissue unmatched by supply, leadung to ischaemia. e.g. due to atheroma, thrombus, spasm or aberrant anatomy; aortic stenosis or hypertrophic cardiomyopathy

8

ECG findings in angina

May be completely normal (high risk patients)

9

What is the gold standard investigation for angina?

Coronary angiography. it is a prelude to angioplasty or coronary bypass surgery

10

Antiplatelets used in coronary disease

aspirin, clopidogrel, ticagrelor

11

Lipid management

statins, Ezetmibe, PCSK9 inhibitors

12

Anti-anginals

nitrates, Ca channel blockers, nicorandil, ivabradine, ranolazine

13

benefits of angioplasty post MI

superior to thrombolysis. less strokes, less repeat MIs

14

What is restenosis post angioplasty?

renarrowing of stents, usually in the first 6 months. due to the exuberant generation of scar tissue.

15

Methods of reducing restenosis

Drug eluting stents and longer duration of dual antiplatelet therapy leadig to slower endotheliasation

16

3 vessel coronary disease is treated how?

CABG

17

Risk of CABG in rest of the body

Stroke, Kidney failure, unable to come off ventilator, poorly healing leg and chest wound, disease in the grafts

18

What intervention is used quickly in NSTEMI and immediately in STEMI?

Percutaneous coronary intervention (PCI) in cath lab