SIHD Flashcards
(46 cards)
what is ischemia
restriction in blood supply
Printzmetals angina is what kind of ischemia?
supply ischemia
chronic stable angina is what kind of ischemia
demand ischemia
unstable angina is what kind of ischemia?
supply ischemia
what two things lead to ischemia?
decreased coronary blood flow and increased oxygen consumption
what things cause increased oxygen consumption?
increased HR, preload, afterload, and contractility
what is preload?
volume of blood in ventricles at the end of diastole
what is afterload?
pressure left ventricle must overcome to eject blood during contraction
if we decrease contractility we decrease what
oxygen consumption
if we decrease HR we decrease/inc what?
decrease O2 consumption and increase coronary perfusion
if we decrease preload what happens
decrease o2 consumption, increase in myocardial perfusion
how do we decrease preload?
venodilation
how do we decrease afterload?
arterial dilation
what happens if we decrease afterload?
decrease in o2 consumption
BP and A1c goals
<130/80
<7%
ASA mechanism of action
irreversible inhibition of COX1 and blocking TXA2 synthesis
what does COX-1 do
increase platelet aggregation and vasoconstriction
what does COX-2 and prostacyclin do
inhibit aggregation and has vasodilation
P2Y12 inhibitors MOA
inhibit ADP induced platelet aggregation with no effect on TXA2, inhibits adenyl cyclase
ASA adverse effects
GI bleed, brain bleed
clopidogrel adverse effects
bleeding, diarrhea, rash
prasugrel side effects
bleeding, diarrhea, rash
ticagrelor side effects
bleeding, bradycardia, heart block, dyspnea
elective PCI pts antiplatelet therapy
ASA indefinitely
low risk bleeding: clopidogrel 6 months
high risk bleeding: DAPT 1-3 months, P2y12 till 12 months
