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Ischemic Heart Disease(IHD) Flashcards

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1
Q

Also called:
Coronary Heart Disease(CHD),
Coronary artery disease (CAD)
Atherosclerotic heart disease

A

Ischemic Heart Disease

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2
Q

condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium

typically occurs when there is an imbalance between myocardial oxygen supply and demand

A

Ischemic Heart Disease

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3
Q

blockage or narrowing (stenosis) of the arteries that supply the heart muscle, often due to a buildup of fatty plaque inside the arteries.

A

Coronary Artery Disease

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4
Q

In majority of patients, it is caused by atherosclerosis

A

Coronary Artery Disease

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5
Q

rarely may be due to aortitis

A

Coronary Artery Disease

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6
Q

rarely may be due to vasculitis

A

Coronary Artery Disease

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7
Q

rarely may be due to autoimmune connective tissue diseases

A

Coronary Artery Disease

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8
Q

Heart rate
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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9
Q

Blood pressure
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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10
Q

Myocardial contractility
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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11
Q

L. Ventricular hypertrophy
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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12
Q

Valve disease e.g aortic stenosis
Is a factor influencing

A

Cardiac work > myocardial O2 demand

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13
Q

Duration of diastole
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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14
Q

Coronary perfusion pressure
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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15
Q

Coronary vasomotor tone
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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16
Q

Oxygenation
- haemoglobin
- O2 saturation
Is a factor influencing

A

Coronary blood flow > myocardial O2 supply

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17
Q

• Chest pain or heaviness
• Dyspnoea: exertional, orthopnoea,
paroxysmal nocturnal dyspnoea
• Ankle swelling
• Palpitations
• Syncope
• Intermittent claudication
• Fatigue

Are common symptoms of

A

Ischemic heart disease

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18
Q

Chest pain or heaviness

A

A common symptom of ischemic heart disease

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19
Q

Dyspnoea: exertional, orthopnoea,
paroxysmal nocturnal dyspnoea

A

A common symptom of ischemic heart disease

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20
Q

Ankle swelling

A

A common symptom of ischemic heart disease

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21
Q

Palpitations

A

A common symptom of ischemic heart disease

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22
Q

Syncope

A

A common symptom of ischemic heart disease
+ a sign of cardiovascular diseases

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23
Q

Intermittent claudication

A

A common symptom of ischemic heart disease

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24
Q

Fatigue

A

A common symptom of ischemic heart disease

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25
Cardiac arrest
A sign of cardiovascular diseases
26
Abnormal heart sounds/Murmurs
A sign of cardiovascular diseases
27
Signs of heart failure
A sign of cardiovascular diseases
28
Cardiac arrhythmias
A sign of cardiovascular diseases
29
Normal physical exam doesn’t exclude
IHD
30
usually occurs on exertion and is relieved by the rest
Angina Pectoris
31
Typically described as a central, squeezing, pressure, heaviness, tightness or pain in the chest.
Angina Pectoris
32
Pain may radiate to the jaw, neck, or one or both arms and may be associated with shortness of breath
Angina Pectoris
33
term that encompasses both unstable angina and myocardial infarction
Acute coronary syndrome (ACS)
34
characterized by new-onset or rapidly worsening (crescendo ……….) on minimal exertion or at rest in the absence of myocardial damage
unstable angina
35
Fixed stenosis Demand-led ischemia Related to effort Predictable Symptoms over long term
Stable angina
36
Dynamic stenosis Supply-led ischemia Symptoms at rest Unpredictable Symptoms over short term
Unstable angina
37
Mild chest pain for less than 15 minute and occurs with exertion, with rapid relief once the patient rests, or by taking sublingual nitrate
Stable angina
38
The amount of exertion necessary to produce the pain Is in
Stable angina
39
May progress to Unstable Angina
Stable angina So the change in the pattern ,severity or character of it must be taken very seriously
40
Chest pain of moderate to severe degree occurs at rest or wakes up a patient from sleep Stays for more than 15 minutes
Unstable angina
41
not relieved by rest or sublingual nitrate
Unstable angina
42
Have to deal with it as seriously as acute MI, patient should be admitted to CCU
Unstable angina
43
Site: retrosternal, radiates to arm, epigastrium, neck Precipitated by exercise or emotion Relieved by rest, nitrates Mild/moderate severity chest pain Anxiety absent or mild No increased sympathetic activity No nausea or vomiting
Angina
44
Site: retrosternal, radiates to arm, epigastrium, neck Often no obvious precipitant Not relieved by rest, nitrates Usually severe chest pain(may be 'silent') Severe anxiety Increased sympathetic activity Nausea and vomiting are common
MI
45
Painless or 'silent' myocardial infarction is not uncommon, particularly in
diabetic patients and the elderly
46
A sign of ischemic chest pain
Levine's sign
47
Clenching of fist in front of chest while describing chest discomfort
Levine’s sign
48
Ischaemia due to fixed atheromatous stenosis of one or more coronary arteries
Stable angina
49
Ischaemia caused by dynamic obstruction of a coronary artery due to plaque rupture or erosion with superimposed thrombosis
Unstable angina
50
Myocardial necrosis caused by acute occlusion of a coronary artery due to plaque rupture or erosion with superimposed thrombosis
Myocardial infection
51
Myocardial dysfunction due to infarction or ischaemia
Heart failure
52
Altered conduction due to ischaemia or infarction
Arrhythmia
53
Ventricular arrhythmia asystole massive mvocardial infarction
Sudden death
54
DM-insulin resistance
A modifiable risk factor for IHD
55
Hypertension
A Modifiable Risk factor for IHD
56
Smoking
A Modifiable Risk factor for IHD
57
Hyperlipidemia
A Modifiable Risk factor for IHD
58
Alcohol
A Modifiable Risk factor for IHD
59
Obesity
A Modifiable Risk factor for IHD
60
Sedentary lifestyle
A Modifiable Risk factor for IHD
61
Diet
A Modifiable Risk factor for IHD
62
Age 45 yrs or more
An Unmodifiable Risk factor IHD
63
Male gender
An Unmodifiable Risk factor IHD
64
History of previous IHD
An Unmodifiable Risk factor IHD
65
Family history of IHD
An Unmodifiable Risk factor IHD
66
Serial ECGs
Investigation of Acute Coronary Syndromes
67
Serial cardiac markers
Investigation of Acute Coronary Syndromes
68
Oxygen
Prehospital care of Acute Coronary Syndromes
69
aspirin
Prehospital care of Acute Coronary Syndromes
70
nitrates
Prehospital care of Acute Coronary Syndromes
71
triage to an appropriate medical center
Prehospital care of Acute Coronary Syndromes
72
Prehospital care of Acute Coronary Syndromes
Oxygen, aspirin, and nitrates and triage to an appropriate medical center
73
Drug treatment of Acute Coronary Syndromes
Analgesics,antiplatelet drugs, antianginal drugs, anticoagulants,
74
Analgesics
Drug treatment of Acute Coronary Syndromes
75
antiplatelet drugs
Drug treatment of Acute Coronary Syndromes
76
antianginal drugs
Drug treatment of Acute Coronary Syndromes
77
anticoagulants
Drug treatment of Acute Coronary Syndromes
78
Angiography
assess coronary artery anatomy
79
Reperfusion therapy includes …… Used for …….
Fibrinolytics, percutaneous coronary intervention or coronary artery bypass surgery Used for Management of Acute Coronary Syndromes
80
Fibrinolytics
Reperfusion therapy
81
percutaneous coronary intervention
Reperfusion therapy
82
coronary artery bypass surgery
Reperfusion therapy
83
Supportive care includes ……. Used for ……
Post-discharge cardiac rehabilitation and chronic management of coronary artery disease Management of Acute Coronary Syndromes
84
Anti-platelet therapy (aspirin +/ clopidogrel)
MI 2ry prevention drug therapy
85
Beta blocker
MI 2ry prevention drug therapy
86
ACE inhibitors/ ARB
MI 2ry prevention drug therapy
87
Statin
MI 2ry prevention drug therapy
88
Additional therapy for control of diabetes + HT
MI 2ry prevention drug therapy
89
Mineralocorticoid receptor antagonist
MI 2ry prevention drug therapy
90
if there is HF or pulmonary congestion
Auscultate Basal crepitations
91
if R. Ventricular hypertrophy is present
left ventricular heave may feel

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