Ischemic or CHD Pt 1

Question 1

An insufficient supply of oxygenated blood results in what?

Answer 1

Ischemia

Blockage of coronary artery(s) results in damage/injury

Question 2

What is ischemia seen on an EKG as?

Answer 2

ST depression

Question 3

Cell death or necrosis is a result of ______

Answer 3

MI (myocardial infarction)

Question 4

MI is seen on an EKG as an ________

Answer 4

ST elevation

Question 5

What is the leading cause of death in the US?

Answer 5

MI

Question 6

What does a ST segment greater than 1mm indicative of?

Answer 6

That there is an acute evolving MI

Question 7

Ischemia may involve an inverted what on EKG?

Answer 7

T wave

Question 8

What is a visible Q on EKG indicative of?

Answer 8

A previous infarction

The Q wave remains abnormal due to scar formation

Question 9

What are the non-modifiable risks?

Answer 9

Advancing Age
Gender- especially men and post menopausal women
Family History

Question 10

What are the modifiable risk factors?

Answer 10

Diabetes
Smoking
HTN
High Cholesterol
Obesity
Sedentary Lifestyle
Stress
Over Consumption of Alcohol

Question 11

What are causes of Ischemic Heart Disease?

Answer 11

Atherosclerosis
Thrombosis 
Coronary Spasm
Decreased Coronary Flow
Abnormal Coronary Artery Development

Question 12

What is the inflammatory process?

Answer 12

Gradual build up of atherosclerotic material
damages arterial walls.
-WBCs respond- inflammatory response further damages walls allowing LDL molecules to infiltrate.
-Fatty (lipid) streak develops. May harden and narrow vessel or may rupture.
-Response to rupture is blood clot formation, may further obstruct artery OR plaque may embolize & block smaller arterial branch.
Ischemia or MI

Question 13

What is angina pectoris?

Answer 13

Chest pain due to myocardial ischemia

Question 14

Stable angina pectoris?

Answer 14

effort induced
short lasting
relieved by rest or NTG

Question 15

Unstable Angina (USA) pectoris tends to?

Answer 15

Lasts longer
More often
Not always related to exertion
NTG temporarily relieves

Question 16

Variant Angina is also known as

Answer 16

Prinzmetal’s Angina

Question 17

Variant Angina occurs?

Answer 17

At rest
Early in the Morning
Thought to be a coronary artery spasm

Question 18

What is Variant Angina often associated with on EKG?

Answer 18

ST segment elevation

Question 19

Besides angina, what are other symptoms associated with IHD?

Answer 19

Fatigue
Silent MI, an MI can be silent ( mild/non-existent symptoms)
Detection of a new murmur post MI
Sudden Death

Question 20

Detection of a new murmur post MI may be due to what?

Answer 20

MR due to pap muscle dysfx/rupture, VSD, LV dilation

Question 21

With sudden death up to what % is due to MI’s

Answer 21

35%

Question 22

What percentage have no symptoms prior to MI?

Answer 22

Up to 50%

Question 23

Men v Women

Symptoms for Men

Answer 23

Typical Chest pressure
pain radiating to neck, jaw, and left arm
nausea
sweating

Question 24

Men v Women

Symptoms for Women

Answer 24

Chest pain
Profound fatigue
Chest- area pressure, constant/intermittent
SOA
Fast, weak pulse
Dizziness, fainting
Nausea
Sweating

Question 25

``` -Relevant Facts for Women- Kills more women annually than ______ More prevalent after _______ More likely than men to ______ More ______ than men's MI's ```

Answer 25

Breast CA+accidents+diabetes Menopause Die within one year of first MI Damaging

Question 26

What are the Diagnostic tests for IHD/CAD

Answer 26

``` Cardiac Cath Echo Stress Echo Nuclear Stress Testing EKG Blood Tests: enzymes, or other markers ```

Question 27

Which diagnostic test is the Gold Standard for IHD/CAD?

Answer 27

Cardiac Cath

Question 28

Stress Echo

Answer 28

Evaluates functional response of heart by detecting WMA's

Question 29

Nuclear Stress Test

Answer 29

Detects perfusion abnormalities

Question 30

Relevant Blood Tests | What cardiac enzymes increase with MI?

Answer 30

``` Troponin Creatinine Kinase (CK) -CK-MB Creatinine phosphokinase (CPK) ```

Question 31

What is bad cholesterol?

Answer 31

LDL

Question 32

What is good cholesterol?

Answer 32

HDL

Question 33

``` Relevant Blood Tests Clotting Factors (Blood Clotting Time) ```

Answer 33

Prothrombin time (pro time, PT time, PTT, INR)

Question 34

Relevant Blood Tests | C-reactive protein (CRP)

Answer 34

An indicator/marker of inflammation in the body

Question 35

Clot Busters (thrombolysis)

Answer 35

Within 3 hours of onset of symptoms - Streptokinase - Urokinase - tPA (tissue plasminogen activator)

Question 36

Statins

Answer 36

Reduce cholesterol, triglycerides

Question 37

Nitrates

Answer 37

Vasodilators, CP relief

Question 38

Antiplatelets

Answer 38

Reduce clot formation

Question 39

Beta Blockers and Calcium Channel Blockers

Answer 39

Reduce workload of the heart