Flashcards in Stable Angina and Coronary Heart Disease Deck (62):
What is angina?
Cardiac chest pain
What is myocardial ischemia?
When there is a mismatch between the myocardial supply and demand of Oxygen and metabolites
What is the most common cause of myocardial ischemia?
Reduced coronary blood flow to the myocardium
What are 2 less common causes of myocardial ischaemia
Reduced oxygen transport (anaemia)
Pathologically increased myocardial oxygen demand
What is the most common cause of reduced oxygen transport?
What is the most common cause of pathologically increased myocardial oxygen demand?
LVH (left ventricular hypertrophy)
What is the most common cause of angina?
What does myocardial ischaemia lead to?
What happens to myocardial oxygen demand when HR and BP increase?
What are 4 lifestyle-related causes of increased myocardial oxygen demand?
After a large meal
Where anatomically is angina often felt?
What is the typical character of angina pain?
Where can angina pain radiate to? (2)
Neck (and jaw)
What 4 systems can cause angina pain?
What are 2 CVS causes of angina pain?
What are 2 Respiratory causes of angina pain?
What are 2 Musculoskeletal causes of angina pain?
Muscle spasm or strain
What are 2 GI causes of angina pain?
What are 2 situations in which myocardial ischaemia occurs with no chest pain?
If patient has diabetes mellitus
What are 3 medical risk factors for coronary artery disease?
What are 4 features you may be able to identify on examination for stable angina?
Abdominal aortic aneurysm
Absent or reduced peripheral pulses
What are 7 investigations you may perform to diagnose stable angina?
Bloods (FBC, etc)
ETT (exercise tolerance test)
Myocardial perfusion imaging
CT coronary angiography
What 2 general medical risk factors would you look at reducing for stable angina?
If stable angina symptoms were not controlled after drug intervention then what would be done?
What are the 2 main types of revascularisation?
PCI (Percutaneous coronary intervention)
CABG (Coronary artery bypass grafting)
What 3 types of drugs would be administered to reduce the disease progression of stable angina and when should they be used?
Statins (if high total cholesterol)0
ACE inhibitors (if increased CV risk and atheroma)
What 4 types of drugs should be used for relief of stable angina symptoms?
Calcium channel blockers
Potassium channel openers
What is done in PCI (percutaneous coronary intervention)?
Stenting regions identified by coronary angiography
What is the most common symptom of coronary heart disease?
What are 3 medical risk factors for coronary heart disease?
What are 3 social risk factors for coronary heart disease?
What are 3 rate limiting drugs to treat coronary heart disease?
What are 2 vasodilating drugs to treat coronary heart disease?
What is the rebound phenomena (in relation to beta blocker)?
When beta blockers are suddenly taken away as treatment it can actually cause an MI
What are 4 contraindications of beta blockers?
Peripheral vascular disease
What are 3 adverse drug reactions of beta blockers?
What is the main nitrate vasodilating drug?
GTN (glyceryl trinitrate)
What are 2 adverse drug reactions to nitrates?
What is the main potassium channel opening drug?
What is the 2 main anti-platelet drugs?
What are 2 examples of statins?
What is the term used to describe when there is a lack of blood supply to an organ/tissue leading to a lack of oxygen supply?
What are the 4 types of hypoxia?
What is hypoxic hypoxia?
When there is either:
1. Low inspired oxygen level
2. Normal inspired oxygen but low partial pressure of oxygen
What is anaemic hypoxia?
Oxygen that is inspired is normal but the oxygen in the blood stream is abnormal
What is stagnant hypoxia?
inspired oxygen is normal but the delivery is abnormal (i.e. occlusion of a vessel)
What is cytotoxic hypoxia?
Oxygen is normal at inspiration but abnormal at the tissues
What is the definition of infarction?
The obstruction of blood flow
What are 4 examples of infarctions?
Trauma (to vessels)
What 4 factors is the extent of damage from an infarction/ischaemia dependant on?
Pattern of blood flow
What is a myocardial infarction?
Cell death due to ischaemia
What is the difference between a major or minor infarction?
The degree of coronary artery occlusion
What is used to detect cardiac cell death?
Positive cardiac biomarkers
What is a STEMI MI caused by?
Completely occluded artery
If the patient is having a STEMI MI what is the main interventional treatment?
PCI in a cath lab
What interventional treatment should be given to a patient with STEMI MI if there is no cath nearby?
What should a patient with suspected ACG be monitiered with in the hospital?
What procedure should patients with NSTEMI be given if they are at high risk?
What are 4 risks of interventional treatment for ACS?
Blood vessel damages
Where is troponin contained in?
Why is troponin in the blood stream a precursor for MI?
Shows that there are problems with myocardial cells