Coronary Artery Disease Flashcards
(30 cards)
What are the three main causes of death in coronary artery disease?
Arrhythmia, pulmonary oedema and hypoxia, mechanical catastrophe.
What are the components of the spectrum of coronary artery disease
Risk factors, atheroma, ischaemic heart disease, heart failure.
List 7 risk factors for coronary artery disease.
Smoking, high cholesterol, high blood pressure, diabetes, inflammation, genetic predisposition, increasing age.
What is atheroma?
A staged process of plaque build-up in arteries; individual lesions become confluent and widespread; mostly asymptomatic.
Where does atheroma occur in coronary artery disease?
In the coronary arteries.
Name 3 clinical syndromes caused by coronary artery disease.
Angina, acute coronary syndrome, heart failure.
What is angina?
Myocardial ischaemia on exertion due to reduced coronary blood flow through narrowed coronary arteries.
What can happen if the lipid core of an atheroma ruptures?
It causes an acute coronary syndrome leading to sudden severe myocardial ischaemia.
What is the 4-stage pathophysiology of atheroma?
- Damage to tunica intima; 2. Foam cells deposit; 3. Fatty streaks form; 4. Atheroma develops.
What substances accumulate in an atheroma?
Macrophages, lipids, calcium, fibrin.
What is the Greek meaning of “atheroma”?
Gruel.
What is the main diagnostic tool for chronic stable angina?
History, supported by evidence of coronary atheroma via CT scan, angiogram, perfusion scan, stress echocardiography, or exercise test.
Name 6 treatments for angina.
Aspirin, statin, beta-blocker, calcium channel blocker, nitrates, ranolazine.
How is chronic stable angina usually managed?
Mostly with medications; PCI as backup therapy.
What distinguishes STEMI from NSTEMI?
ST elevation indicates complete occlusion (STEMI); no ST elevation in NSTEMI.
Why is ST elevation significant in acute coronary syndrome?
It shows complete anoxia and quick cell death; “Time = Muscle”.
What are the key treatments for STEMI?
(Not explicitly listed, but implied: urgent reperfusion therapy).
Name 5 medical treatments used in acute coronary syndrome.
Dual antiplatelets (aspirin + ticagrelor/clopidogrel)
Statin (atorvastatin)
Beta-blocker (bisoprolol/carvedilol)
ACE inhibitor (ramipril/enalapril),
Mineralocorticoid receptor antagonist (eplerenone/spironolactone).
Name 3 short-term complications of myocardial infarction.
Ventricular arrhythmia, myocardial rupture, ischaemic mitral regurgitation.
Name 3 long-term complications of myocardial infarction.
Ventricular aneurysm, heart failure, ventricular arrhythmia.
What does “ischaemic MR” refer to?
Ischaemic mitral regurgitation following myocardial infarction.
What is a ventricular aneurysm?
A bulging or dilation of the ventricular wall as a long-term complication of myocardial infarction.
What is the role of troponin in myocardial ischaemia?
Troponin (TnT-I, TnT-C, TnT-T) regulates tropomyosin, which blocks myosin binding sites; Ca²⁺ binds troponin during systole for contraction.
What imaging assesses perfusion in the myocardium?
Perfusion scan.
