Stable Angina and Coronary Heart Disease Flashcards Preview

Jamie Cardiovascular Pathology > Stable Angina and Coronary Heart Disease > Flashcards

Flashcards in Stable Angina and Coronary Heart Disease Deck (62):
1

What is angina?

Cardiac chest pain

2

What is myocardial ischemia?

When there is a mismatch between the myocardial supply and demand of Oxygen and metabolites

3

What is the most common cause of myocardial ischemia?

Reduced coronary blood flow to the myocardium

4

What are 2 less common causes of myocardial ischaemia

Reduced oxygen transport (anaemia)
Pathologically increased myocardial oxygen demand

5

What is the most common cause of reduced oxygen transport?

Anaemia

6

What is the most common cause of pathologically increased myocardial oxygen demand?

LVH (left ventricular hypertrophy)

7

What is the most common cause of angina?

Coronary atheroma

8

What does myocardial ischaemia lead to?

Angina

9

What happens to myocardial oxygen demand when HR and BP increase?

Demand increases

10

What are 4 lifestyle-related causes of increased myocardial oxygen demand?

Exertion
Stress
Cold weather
After a large meal

11

Where anatomically is angina often felt?

Retrosternally

12

What is the typical character of angina pain?

Tight band/heavy/pressure

13

Where can angina pain radiate to? (2)

Neck (and jaw)
Arms

14

What 4 systems can cause angina pain?

CVS
Respiratory
Musculoskeletal
GI

15

What are 2 CVS causes of angina pain?

Aortic dissection
Pericarditis

16

What are 2 Respiratory causes of angina pain?

Pneumonia
Pleurisy

17

What are 2 Musculoskeletal causes of angina pain?

Cervical disease
Muscle spasm or strain

18

What are 2 GI causes of angina pain?

Gastro-oesphageal reflux
Pancreatis

19

What are 2 situations in which myocardial ischaemia occurs with no chest pain?

Elderly
If patient has diabetes mellitus

20

What are 3 medical risk factors for coronary artery disease?

Diabetes mellitus
Hypertension
Hyperlipidaemia

21

What are 4 features you may be able to identify on examination for stable angina?

Tar Stains
Obesity
Xanthalasma
Corneal arcus
Abdominal aortic aneurysm
Absent or reduced peripheral pulses

22

What are 7 investigations you may perform to diagnose stable angina?

Bloods (FBC, etc)
CXR
ECG
ETT (exercise tolerance test)
Myocardial perfusion imaging
CT coronary angiography
Cardiac catherisation

23

What 2 general medical risk factors would you look at reducing for stable angina?

BP
Cholesterol

24

If stable angina symptoms were not controlled after drug intervention then what would be done?

Revascularisation

25

What are the 2 main types of revascularisation?

PCI (Percutaneous coronary intervention)
CABG (Coronary artery bypass grafting)

26

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)
Asprin

27

What 4 types of drugs should be used for relief of stable angina symptoms?

Calcium channel blockers
Nitrates
Potassium channel openers
Beta blockers

28

What is done in PCI (percutaneous coronary intervention)?

Stenting regions identified by coronary angiography

29

What is the most common symptom of coronary heart disease?

Angina

30

What are 3 medical risk factors for coronary heart disease?

Hypertension
Hyperlipidaemia
Hyperglycaemia

31

What are 3 social risk factors for coronary heart disease?

Male
Post-menopausal
Smoking

32

What are 3 rate limiting drugs to treat coronary heart disease?

Beta blockers
Ivabradine
CCBs

33

What are 2 vasodilating drugs to treat coronary heart disease?

CCBs
Nitrates

34

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

35

What are 4 contraindications of beta blockers?

Asthma
Peripheral vascular disease
Heart failure
Bradycardia

36

What are 3 adverse drug reactions of beta blockers?

Fatigue
Impotence
Bradycardia

37

What is the main nitrate vasodilating drug?

GTN (glyceryl trinitrate)

38

What are 2 adverse drug reactions to nitrates?

Headache
Hypotension

39

What is the main potassium channel opening drug?

Nicorandil

40

What is the 2 main anti-platelet drugs?

Asprin
Clopidigrol

41

What are 2 examples of statins?

Simvastatin
Pravastatin

42

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?

Hypoxia

43

What are the 4 types of hypoxia?

Hypoxic
Anaemic
Stagnant
Cytotoxic

44

What is hypoxic hypoxia?

When there is either:
1. Low inspired oxygen level
2. Normal inspired oxygen but low partial pressure of oxygen

45

What is anaemic hypoxia?

Oxygen that is inspired is normal but the oxygen in the blood stream is abnormal

46

What is stagnant hypoxia?

inspired oxygen is normal but the delivery is abnormal (i.e. occlusion of a vessel)

47

What is cytotoxic hypoxia?

Oxygen is normal at inspiration but abnormal at the tissues

48

What is the definition of infarction?

The obstruction of blood flow

49

What are 4 examples of infarctions?

Thrombosis
Embolism
Strangulation
Trauma (to vessels)

50

What 4 factors is the extent of damage from an infarction/ischaemia dependant on?

Time
Tissue/organ affected
Pattern of blood flow
Previous diseases

51

What is a myocardial infarction?

Cell death due to ischaemia

52

What is the difference between a major or minor infarction?

The degree of coronary artery occlusion

53

What is used to detect cardiac cell death?

Positive cardiac biomarkers

54

What is a STEMI MI caused by?

Completely occluded artery

55

If the patient is having a STEMI MI what is the main interventional treatment?

PCI in a cath lab

56

What interventional treatment should be given to a patient with STEMI MI if there is no cath nearby?

Thrombolysis

57

What should a patient with suspected ACG be monitiered with in the hospital?

Cardiac moniter

58

What procedure should patients with NSTEMI be given if they are at high risk?

Angiogram

59

What are 4 risks of interventional treatment for ACS?

Bleeding
Blood vessel damages
MI
Stroke

60

Where is troponin contained in?

Cardiac myocytes

61

Why is troponin in the blood stream a precursor for MI?

Shows that there are problems with myocardial cells

62

What are 4 drug types used to treat MI

Asprin
B blockers
ACEI
Statins