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Flashcards in Ischemic Heart Disease Deck (40):
1

Ischemic Heart Disease is also know as?

Coronary heart disease, or coronary artery disease

2

Ischemic heart disease is primarily cause by?

Artherosclocrosis

3

Artherosclocrosis results from?

From decreases blood flow to the heart and leads to reduced oxygen delivery

4

When does angina occur?

Demand > Supply 

5

How does IHD present itself?

  • Chest pain or pressure
  • Discomfort in
    • Neck 
    • Jaw
    • Shoulder or arm 
  • Pain accumanied with nausea or vomiting 

6

Female patients often describe symptoms as?

Indigestion or acid feeling

7

IHD occurs in women or men more?

men 

8

What forms when someone has Artherosclorosis?

A plaque forms this is what causes the reduced oxygen 

9

Stable angina is classified as pain lasting?

less than 10 minutes

10

Angina lasting between 10-15 minutes is known as?

Variant 

11

Unstable angina is when the pain lasts for?

more than 20 minutes 

12

Chest pain is _____ during stable angina

predictable

13

The onset of variant angina is?

gradual 

14

In unstable angina the pain is _____ and there is ____ onset

severe and the onset is new 

15

Stable angina or occurs upon?

Exertion 

16

Variant angina often occurs ____ and at ____ 

in the morning and at rest 

17

Unstable angina occurs ____ or at _____

exertion or at rest 

18

What are the modifiable risk factors of Ischemic heart disease

The Fat Smoker Checked His Glucose Monitor and his head began to BOIL he then Drank some BEER

  • Tobacco smoking
  • Hypercholesterolemia 
  • DM
  • HTN
  • Obesity 
  • Alcohol 

19

What are the non-modifiable risk factors for IHD?

45 + 10 +10 

  • Men > 45
  • Females >55 
  • FH of CVD 
    • First degree relative 
    • Females < 65 
    • Men <55 

20

Beta blocker ____ HR

_____ Cardiac contractility 

_____ Systolic Pressure

____ Left Ventricle Volume 

Decrease all

21

What is 1st line therapy for IHD?

Beta blockers 

22

What are the 3 preferred beta blockers?

Carvedilol, metoprolol succinate, bisoprolol 

23

Beta Blockers are contra indicated with patients with?

Severe bradycardia (<60 bpm) 

AV conduction med Digoxin, verapamil, diltiazem 

Asthma, COPD, DM, HF 

 

24

CCBs are second line for IHD decrease?

HR

25

Amlodipine is a preferred ____

CCB

26

CCBs should not be used when?

Digoxin or BB 

HF 

same as BBs 

27

You should not use ____ in patients with variant angina

BBs 

28

What is the 2nd/3rd line for IHD?

Nitrated long acting

29

What do nitrates do?

WHat are they limited by?

 

Decrease wall tension, preload and oxygen demand 

Limited in tolerance development thats why you need 8-12 hours of non nitrate therapy 

30

Nitrates should not be used with?

Patients wiht _____ hypotension 

and cause ____ depletion 

PDE-5 inhibitors 

severe hypotension and can cause volume depletion 

31

All patients should use ____ release nitroglycerin 

 

IR 

32

How do you educate the patient to use nitroglycerin tablets?

  1.  ___ ___ when administering the medication, have phone close by.
  2.  Place __ tablet under the tongue and allow it to dissolve.
  3.  If pain persists after ___ minutes, administer the 2nd tablet.
  4.  Call ____ after administering ___ tablet.
  5.  May administer a 3rd tablet if pain continues ____ after the 2nd tablet for a max of ___ tablets in 15 minutes.

  1. Sit down 
  2. 1 tablet 
  3. 5 minutes 
  4. Call 911 after admin of 2nd tab
  5. 5 minutes, max of 3 tabs in 15 minutes 

33

  1.  If a new bottle, prime pump with ____ test sprays
  2.  When pain occurs, spray 1-2 sprays into mouth while sitting down and phone close by. Do not ___, ____ or spit out the spray for at least 5- 10 minutes.
  3.  Wait 5 minutes, if pain persists may spray a ___ spray and call 911
  4.  Replace cap on the bottle
  5.  If bottle is not used more than 6 weeks must prime again

  1. 5-10
  2. swallow or inhale 
  3. 3rd 

34

Ranolazine is ____ line for IHD and it has no effect on?

2nd 3rd line 

no effect on HR or BP 

35

Ranolazine contraindications

  • Hepatic cirrhosis 
  • Use with CYP3A inducers  
    • Rifampin, carbamazepine, phenytoin, phenobarbital

36

Revascularization should be used when?

  • Max tolerable meds are used and symptoms are still occuring 
  • High risk patients multiple comorbidities 

37

What is the antiplatelet therapy used after PCI?

Aspirin 81 mg forever

Clopidogrel 75 mg daily, ticogrelor 90 BID or Prasugrel 10 mg for 1 year

38

Want to treat Bp if it is >?

140/90

39

Consider ____ screening in High risk patients as well as?

DM

Depression and Kidney function

 

 

40

CCBs like ____, ___ and ____ should be first choice for ____ angina

Verapamil, diltiazem and nifedipine 

for variant angina