Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Cards Ischemia & ACS
Cardiology
| Question | Answer |
|---|---|
| 2 pathways for ischemic heart dz progression | Progressive intraluminal narrowing; Sudden disruption/fissuring of plaques |
| Progressive intraluminal narrowing tend to: | produce collateral blood supply & more likely to cause worsening stable/unstable angina (>75%) |
| Sudden disruption/fissuring of plaques likely to: | rupture, causing ACS (Acute Coronary Syndrome) or Acute MI (25-75%) |
| Tobacco: CAD risks | 2x risk for 1/2 to 1 pack/day; 3x risk for > 1 pack/day; risk declines 50% after one year of tobacco cessation |
| CAD signs/symptoms | Chest pain/pressure/tightness; Jaw/ neck/ throat/scapular/ arm pain; SOB/ Dyspnea on exertion; N&V; Diaphoresis; Fatigue |
| MI Pathophysiology steps | 1 Plaque rupture; 2 Platelet activation/aggregation; 3 Fibrin generation; 4 Thrombus formation |
| Cardiac ischemia risk factors | Age; Gender ? FH; Sedentary Lifestyle; Tobacco; HTN; DM/insulin resistance; Hyperlipidemia |
| Causes of coronary ischemia leading to chest pain | Atherosclerosis; Vasospastic disorders; stenosis or HCM; Coronary thrombosis/ embolization; Acute aortic dissection |
| Before a dx of CAD, diabetic patients' risk of MI = | risk of non-diabetic patient with hx of prior MI |
| Almost all MI’s result from: | coronary atherosclerosis & superimposed coronary thrombosis |
| What percent of MIs are unrecognized by clinicians? | 30% |
| Most common MI complaint other than chest pain = | dyspnea |
| Which sx of MI is report most commonly in the elderly? | Shortness of breath |
| Symptoms of MI in elderly patients commonly include: | confusion, syncope, and vertigo |
| MI tx: morphine, oxygen, NTG, ASA. What next? | Beta blockers |
| In a 65yo male with hx of CP x7 minutes with SOB, negative TnT, normal ECG, what is next step in mgmt? | Repeat TnT in 3 hrs |
| Elevated troponin is a sensitive AND specific indicator of: | cardiac myonecrosis (2/2 troponin release from myocytes into circulation) |
| In patients with ESRD, what cardiac enzyme changes should be used to define an MI? | Dynamic changes in TnT values >20% over 6-9 hours |
| What is prognostic significance of an elevated troponin level? | TnT elevation imparts a worse prognosis, regardless of the underlying etiology |
| Crushing CP, dyspnea, palpitations, radiation to neck or left arm: | Angina (if lasts minutes), AMI if lasts >30 minutes. Acute Ischemia: ST elevation; Injury: T wave depression; Infarct: Q wave |
| Prinzmetal angina: | Vasospastic Angina; W<50 yo; assoc w/migraine, Raynaud; early AM; ST elevation; usually RCA |
| Tobacco: CAD risks | 2x risk for 1/2 to 1 pack/day; 3x risk for > 1 pack/day; risk declines 50% after one year of tobacco cessation |
| Most common etiology of angina pectoris: | atherosclerotic stenosis of coronary arteries |
| Etiologies of angina pectoris: | coronary artery sclerosis; artery spasm; congenital; AS; HCM; pHTN; HTN; collagen vasc dz |
| Stable angina: sxs | substernal pressure with exertion; relieved by rest |
| Unstable angina: sxs | chest discomfort at rest, or new & severe (within 2 months and brought on by exertion), or increasing frequency, duration, intensity |
| Anginal equivalent = | DOE caused by myocardial ischemia |
| Silent ischemia (evidence on stress test) is more common among: | patients with DM |
| In MI, CK-MB rises within: | 4-8 hours; peaks at 12-24 hours; normal in 2-3 days |
| In MI, LDH rises within: | 14-24 h; peak at 2-3 days; normal in 8-14 days |
| In MI, troponins rise within: | 4 hours; peak at 36 hours; normal in (7 days for TnI, 10-14 days for TnT) |
| Which med decreases comorbidity and comortality in CAD? | Beta blocker |
| Treatment of choice for Prinzmetal angina | Cardizem (diltiazem) |
| Which coronary artery is associated with a lateral MI? | Left circumflex |
| Which coronary artery is associated with an anterior MI? | LAD (left anterior descending). V2-V4 on ECG |
| Which coronary artery is associated with an inferior MI? | RCA (right coronary artery) |
| Which measure (lipids, BMI, homocysteine level) is the best predictor of cardiovascular mortality? | Homocysteine level |
| Which coronary artery is associated with a septal MI? | LAD (V1-V2 on ECG) |
| Which coronary artery is associated with an anterolateral MI? | left main (V4-V6 on ECG) |
| Which coronary artery is associated with a posterior MI? | RCA (right coronary artery) (ST depression, changes at V1-V2 on ECG) |
| Most specific cardiac enzyme for ACS | troponin I |
| Which cardiac enzyme rises earliest | myoglobin |
| In ACS, which enzymes becomes elevated in 3-12 hours | troponin I, troponin T, CK-MB |
| In MI, myoglobin peaks within | 0-1 hr (normal within 36 hours) |
| CAD risk factors | M>F. AA>W. Lower SES. FH. Obesity. Decreased physical activity. Smoking. HTN. LDL >160. HDL <40. DM. LVH. |
| CAD screening | Smoking. BP. Chol (M>35 yo, F >45yo). AAA: 65-75 if h/o smoking; exam & US |
Created by:
Abarnard
Popular Medical sets