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Flashcards in deck_835133 Deck (24):

Give some common causes of chest pain

Lungs (pneumonia, pulmonary embolism, pneumothorax)GI (oesophagus -- reflux, peptic ulcer disease, cholecystisis)Chest wall (costochondritis, fibrositis, skin problems)CVS (MI, angina, pericarditis, aortic dissection)


Give some modifiable risk factors for coronary atheroma

ExerciseSmokingDiet -- hyperlipidaemia, obesityStressHypertensionDiabetes mellitus


Give some non-modifiable risk factors for coronary atheroma

Gender -- males have higher risk (sucks to be you Matt :-P)Increasing ageFamily history


What are the four main modifiable risk factors for coronary atheroma?

HyperlipidaemiaSmokingHypertension Diabetes mellitus (doubles risk of ischaemic heart disease)


Describe angina

Is caused by decreased blood supply to the myocardium-- during diastole, the filling period of coronary arteries is less so there is less blood supply to the myocardium-- have partially occluded/narrowed coronary arteries in anginaDemand of blood to ten myocardium is not met by the supply which causes ischaemia and chest pain


Describe myocardial infarction

Coronary artery lumen is occluded (thrombus from ruptured atheroma tours plaque)Blood cannot supply cardiac muscleIschaemia occurs followed by infarction


Give some clinical signs of angina

ST depression Narrowed coronary arteries appear on an angiogram


Give some symptoms of angina

Central chest pain on exertion -- returns to normal on resting Shortness of breath (dyspnea)Nausea, dizziness, vomitingFatigue


Signs do myocardial infarction

ST elevation (may or may not be depending on if infarction is full thickness or not)High creatine kinase and troponin 1 levels


What is a non ST elevated myocardial infaction?

Non- full thickness infarction


Give some symptoms of myocardial infarction

Central crushing chest pain, may radiate to chest and shoulders. Is not relieved by restPallorNauseas, dizziness (can lead to syncope), vomiting


What is unstable angina?

Ischaemic central chest pain which can occur at rest


What is unstable angina caused by?

A transient blockage which can be due to platelet aggregation, coronary thrombosis or coronary artery spasms -- due to ischaemia rather than and increase in demand for oxygen


Give some symptoms of acute pericarditis

Central stabbing chest painPain is increased by lying down or deep breathing Pain is relieved by sitting down and leaning forwardPain can be referred to the shoulders (C4 dermatome)PalpitationsShortness of breathFatigue


Give some signs of acute pericarditis

PallorFiction rub upon auscultationCan see fluid collection in pericardial sac by echo or ultrasoundMay see cardiac enlargement on an x-raySaddle-shaped ST elevations which are unrelated to the distribution of C arteries


Give some causes of acute pericarditis

Viral or bacterial infectionTuberculosisHIVUraemia pericarditis due to untreated kidney failureMyocardial infarction Metastasising cancers to pericardiumInflammatory disease


Where can ischaemic chest pain be felt?

CentralRetrosternalLeft sided


How can ischaemic chest pain be described?

TighteningHeavy CrushingConstricting PressureBurning epigastric pain for an inferior MI


Describe an atheroma tours plaque

Plaque with a necrotic centre and fibrous cap found in the coronary vessels which occludes the lumen of the artery -- occurs when more than 70% f the lumen is occluded


When can episodes of stable angina occur?

ExertionEmotion especially after meals and in cold weather


Give some treatments for acute episodes of angina

Sublingual nitrate spray or tablet


Give some treatment that prevents episodes of angina

Beta blockersCa2+ channel blockersOral nitrates


Give some treatments that prevents cardiac events

AspirinStatinsACE inhibitors


Why does unstable angina develop?

Due to an increased formation of an atheromatous plaque. Eh lumen is being occluded more