Coronary heart disease

Question 1

coronary heart disease

Answer 1

• Stable accumulation of flow restriction
  
  • Angina → 70% of the diameter of vessel needs to be obstructed to cause pain
• Unstable clinical syndromes
  
  • Heart attack
    
    • NSTEMI (Type 1 and type 2 )
    • STEMI

Question 2

aetiology

Answer 2

atherosclerosis of coronary vessels

Question 3

clinical presentations

Answer 3

sudden death
cardiogenic shock
type 2 MI

Question 4

sudden death

Answer 4

• 50% of deaths from coronary heart disease are sudden
  
  • 2/3’s of these sudden deaths are the first manifestations of symptoms

Question 5

cardiogenic shock

Answer 5

• inadequate systemic perfusion due to cardiac disfunction
  
  • 90% mortality rate
  • caused by MI
• Can lead to pulmonary oedema, ischaemia and progressive myocardial dysfunction

Question 6

symptoms

Answer 6

• Crushing central chest pain
• Dull, visceral pain

Question 7

pathophysiology

Answer 7

• Formation of atherosclerotic plaque
• Atherosclerotic plaque ruptures leading to total or partial occlusion of a coronary artery
• This can lead to cardiac arrest

Question 8

differential diagnosis of chest pain

Answer 8

GI tract
musculoskeletal
pericarditis
pleuritic pain
MI
PE
dissection of aorta

Question 9

management

Answer 9

• Drugs
  
  • Aspirin, beta blockers, statin, ACEi
• Lifestyle
  
  • Stopping smoking and eating a good diet
• Revascularisation
  
  • CABG