Coronary Artery Disease

Question 1

True or false: CAD disease is not a major cause of death

Answer 1

False

Question 2

What is the main cause of CAD?

Answer 2

Atherosclerosis

Question 3

What types of ACS are there?

Answer 3

Unstable angina, MI, and sudden cardiac death

Question 4

What types of chronic ischemic heart disease are there?

Answer 4

Stable angina and congestive heart failure

Question 5

What is a manifestation of coronary artery disease?

Answer 5

Angina

Question 6

What causes angina pectoris?

Answer 6

Atherosclerosis mainly, vasospasms, and thrombosis

Question 7

What is the patho physiology of angina?

Answer 7

Inadequate perfusion leads to ischemia which leads to chest pain

Question 8

What are manifestations of angina?

Answer 8

Chest pain which is triggered on exertion

Question 9

What are the characteristics of stable angina?

Answer 9

It deals with a fixed plaque which impedes perfusion and causes transient pain from the ischemia

Question 10

What is transient pain?

Answer 10

Pain that can be relieved when the trigger is taken away

Question 11

True or false: stable angina is triggered by exertion

Answer 11

True

Question 12

What are the characteristics of unstable angina?

Answer 12

Deals with an unstable plaque that can burst, and if it bursts a thrombus will form as platelets aggregate.

Question 13

What do platelets release when the aggregate on the atherosclerotic plaque and what results from it?

Answer 13

Prostaglandins which causes a vasospasm

Question 14

True or false: pain in unstable angina occurs only on exertion.

Answer 14

False. Pain can occur nocturnally and at rest too

Question 15

What is variant/vasospastic angina?

Answer 15

No atherosclerosis is present, however vasospasm occurs in the artery causing ischemia and chest pain

Question 16

When does variant/vasospastic angina occur?

Answer 16

Nocturnally and at rest

Question 17

What are manifestations of angina?

Answer 17

Squeezing or burning chest pain, sometimes accidentally thought to be heart burn or indigestion

Question 18

What subcategories of CAD are there?

Answer 18

Acute coronary syndromes (CAS) and chronic ischemic heart disease

Question 19

What is the treatment for angina?

Answer 19

Decrease activity, nitro-glycerin

Question 20

What can be prevented if you treat angina?

Answer 20

MI

Question 21

What is a myocardial infarction based on an ECG?

Answer 21

S-T Elevated MI STEMI

Question 22

Define the characteristics of a MI

Answer 22

It is the end point of CAD, it is life threatening and it has an acute onset

Question 23

What is the etiology of a MI?

Answer 23

Mainly atherosclerosis, a hemorrhage or a coronary artery spasm (any artery in the coronary circuit)

Question 24

What is the Patho of a MI?

Answer 24

Atherosclerosis leads to a complicated lesion which results in ischemia, wish ischemia anaerobic respiration happens and then metabolic acidosis which causes arrhythmias leaving the heart unable to pump properly

Question 25

What five factors determine how large an infarct is?

Answer 25

Affected vessel (how much tissue is affected) Extent of occlusion Duration of ischemia Metabolic status of the heart (HR, BP, rhythm) Collateral circulation

Question 26

What two types of MIs are there?

Answer 26

Subendocardial infarct (NSTEMI) and a transmural infarct (STEMI)

Question 27

What part of the heart is affected in a subendocardial infarct?

Answer 27

Inner 1/2 to 1/3 of the ventricle wall

Question 28

What part of the heart is affected in a transmural infarct?

Answer 28

Entire ventricle wall

Question 29

Which type of MI is more serious?

Answer 29

Transmural

Question 30

Which vessels are occluded to cause a subendocardial infarct?

Answer 30

Distal vessels, not a main artery

Question 31

Which vessels are occluded to cause a transmural infarct?

Answer 31

One main artery, it is a proximal occlusion

Question 32

What are manifestations of an MI?

Answer 32

Severe chest pain that radiates into the jaw, neck or left arm Anxiety Tachycardia Nausea and vomiting

Question 33

How can you diagnose an MI?

Answer 33

ECG Angiogram Blood work

Question 34

What do you look for in blood work to diagnose an MI?

Answer 34

Troponin I and T Myoglobin (carries O2 in heart muscle) CKmb

Question 35

Treatment of an MI (STAT tx)

Answer 35

STAT medical attention Thrombolytic & anti coag & anti arrhythmic used at same time O2 for hypoxia Opioids for pain

Question 36

Once stabilized what are the treatments for an MI?

Answer 36

IV diuretic Negative inotrope Vasodilator ALL DEC STRESS ON HEART Revascularization surgery (angioplasty if minimal or bypass if angioplasty is not possible)