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Flashcards in Chronic Stable Angina Deck (19):
1

atherosclerotic narrowing of one or more major coronary arteries

Coronary heart disease (CHD)/coronary artery disease (CAD) - Includes angina pectoris, unstable angina, acute myocardial infarction

2

imbalance between myocardial oxygen supply and demand resulting from atherosclerotic CAD

Ischemic heart disease (IHD)

3

clinical syndrome of myocardial ischemia characterized by a deep, poorly localized chest or arm discomfort associated with physical exertion or emotional stress and relieved promptly by rest or nitroglycerin

Angina Pectoris

4

constellation of clinical symptoms that are compatible with acute myocardial ischemia

Acute coronary syndrome

5

i. ST-segment elevation requiring immediate reperfusion therapy (STEMI)
ii. May be referred to as Q-wave MI

Acute myocardial infarction (AMI)

6

i. Ischemia is severe enough to cause sufficient myocardial damage and the release of markers of myocardial injury
ii. May be referred to as non-Q-wave MI

Non-ST-segment elevation MI (NSTEMI)

7

No biochemical markers of myocardial necrosis are released

Unstable Angina

8

clinical syndrome of rest pain and reversible ST-segment elevation without enzyme elevation indicating AMI, usually due to coronary vasospasm

Variant angina

9

percutaneous placement of a catheter in the femoral artery and advancement through the vasculature to the tip of the coronary arteries; radiocontrast dye is injected to determine the location and extent of atherosclerosis

Coronary angiography

10

also known as angioplasty, a balloon catheter is placed during angiography and is inflated to re-open the diseased vessel; an intracoronary stent can then be placed to maintain patency of the vessel

Percutaneous coronary intervention

11

Pathophysiology of Ischemic Heart Disease/Coronary Artery Disease

1. Myocardial demand exceeds supply (perfusion)
2. Atherosclerosis

12

Myocardial oxygen demand (MVO2) is determined by

work load

13

Determinants of myocardial oxygen demand

heart rate, contractility, intramyocardial wall tension during systole

14

Oxygen supply is determined by

coronary blood flow and oxygen extraction

15

Normal oxygen extraction

70 – 75%

16

Oxygen extraction plateaus at

80%

17

can limit oxygen supply and cause ischemia

Atherosclerotic plaques

18

atherosclerotic plaques are Usually caused by

significant CAD (defined angiographically)
i.  70% diameter stenosis of at least one major epicardial artery
ii.  50% diameter stenosis of the left main coronary artery

19

Describe Atherosclerosis

a. Endothelial dysfunction