Flashcards in Ischaemic Heart Disease Deck (119)
Where are the possible origins of chest pain?
Lungs and pleura
GI system; oesophagus, stomach, gall bladder
CVS- heart and great vessels
What can cause chest pain originating from the lungs and pleura?
What can cause chest pain originating from the oesophagus?
What can cause chest pain originating from the stomach?
Peptic ulcer disease
What can cause chest pain originating from the gall bladder?
What components of the chest wall can cause chest pain?
What can cause chest pain originating from the ribs?
What aspects of the CVS can cause chest pain?
What can cause chest pain originating from the myocardium?
What can cause chest pain originating from the pericardium?
What can cause chest pain originating from the aorta?
What kind of risk factors are there for coronary atheroma?
Modifiable and non-modifiable
What are the non-modifiable risks for coronary atheroma?
Male gender (females catch up after menopause)
What are the modifiable risk factors for coronary atheroma?
What are the most important risk for coronary atheroma?
What does coronary atheroma lead to?
Ischaemic heart disease
By how much does diabetes mellitus increase the risk of ischaemic heart disease?
What is the nature of ischaemic chest pain?
Central, retrosternal, or left sided
Pain may radiate to shoulders and arms, with the left side more common than right, along with the neck, jaw, epigastrum and back
Can ischaemia present with pain in other areas, but not the chest?
How is ischaemic chest pain described as?
Tightening, heavy, crushing, constricting and pressure
Occasionally, the pain is described as a burning epigastric pain
When is ischaemic chest pain particularly described as burning epigastric pain?
In an inferior MI
How does ischaemic chest pain vary?
In intensity, duration, onset, precipitating, aggravating and relieving factors
Do the symptoms associated with ischaemic chest pain vary?
What happens to the symptoms of ischaemic chest pain?
They get progressively worse, from stable angina to unstable angina, to MI
When does angina occur?
When a plaque occludes more than 70% of the lumen
How does stable angina develop?
Atheromatous plaques, with a necrotic centre and fibrous cap, build up in the coronary vessels, leaving less space for the passage of blood. This leads to ischaemia of the myocardium
Describe the chest pain in stable angina
Typical ischaemic chest pain in brief episodes, brought on by exertion, emotion, particularly after meals and in cold weather
What is the chest pain in stable angina described as?
Mild to moderate pain
How are acute episodes of angina treated?
Sub-lingual nitrate spray/tablet