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Flashcards in stable coronary art. disease Deck (27):
1

what is diff between stable and unstable CAD

stable
- athersclerosis where blood can still pass
unstable
- athero, but a thrombus has formed - occlusion

2

biggest risk factor

age

3

7 major risk factors for CAD

1. age
2. gender
3. smoking
4. HT
5. dyslipidemia
6. diabetes
7. fam. Hx

4

what is relationship to smkoing

quantity relevant
- risk reduction in 3 years

5

what is Fam Hx importance

polygenic
- most important in younger patients

6

what is angina

symptom due to myocardial ischemia from myocardial O2 demand that is not being met

7

4 possible DDx of chest pain

1. MSK
2. GI
3. pulm and mediastinal
4. psych

8

what is Sx of angina

not really pain
- pressure/tightness
- can radiate to arm and neck

9

3 things NOT char of angina

1. location
- only in middle lower abdo
- localized to a fingertip
2. character
- reproduced by movement or palpation
- pleuritic
3. duration
- few seconds or for many hours

10

5 precipitantas

1. excercise
2. emotion
3. eating
4. cold
5. sex

11

4 levels of chest pain by activity

1. normal
2. > 2 level blocks of > 1 flight
3.

12

def. of typical, atypical and noncardiac angina

Typical - all three
1. substernal chest dscomfort
2. provoked by exertion or emotion
3. releived by rest or nitro
Atypical
2/3
Non-caridac
1 or less

13

who are the best people to give further testing to

those in the intermediate risk in PRE-test prob

14

2 main types of diagnostic testing and their subtypes

1. funtional
- exercise
- nuclear
- stress ECHO
2. structural
- coronary angiogram
- CT coronary angio

15

2 main components of all functional testing

1. stress
2. test

16

3 ways we can stress

1. excercise
2. vasodilators
- persatine
- adenosine
3. pharma
- dobutamine

17

what what amount of stenosis is there Sx

excercise - 70%
rest - 90%

18

what is progression in terms of Sx

1. blood flow changes
2. wall motion abnormal
3. ECG changes
4. Pain - Sx - not till late

19

what is excercise testing

65% accurate
- treadmill and ECG

20

what is nuclear testing

85% accurate
- give radio tracer
- look at wall take up during rest and activity with SPECT tracer

21

2 types of defect that can be seen in nuclear and what they mean

1. reversible - ischemia
2. fixed - infarct

22

what is ECHO

90% accurate
- normal heart thickens when contracted by 50%
- look for this wall motion abnormalitiy

23

what is gold standard

coronary angiography
- invasive
- 1/1000 risk of seriosu complication

24

look at pre-test prob. stuff

do it

25

4 non-pharma mgmt of CAD

1. excercise
2. weight loss
3. med. diet
4. smoking cess

26

4 meds

1. antiplatelelt - ASA
Anti anginal
2. B-blockers
3. nitrates
4. CCBs

27

3 interventions for CAD

1. percutaneous coronoary interventipon
2. stent - drug eluting
3. CABG - major

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