Ischaemic Heart Disease Flashcards Preview

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Flashcards in Ischaemic Heart Disease Deck (11):
1

Pathophysiology of angina

Atheromatous plaque builds up in coronary vessels, occludes the lumen, reduces blood supply to the myocardium, causes ischaemia.
Brought on by exertion as the O2 demand of the heart increases, and diastole shortens

2

Difference between stable and unstable angina

Stable = pain in exertion, relieved by GTN spray
Unstable = pain at rest, not relieved by GTN spray

3

Pathophysiology of MI

Plaque/thrombus completely occludes vessel, leading to an infarct in the myocardium

4

Difference between NSTEMI and STEMI

NSTEMI: infarct not full thickness of myocardium, not ST elevation
STEMI: infarct is full thickness of myocardium

5

Investigations of angina

Exercise stress test
ECG shows ST depression

6

Investigation of an MI

ECG changes: ST elevation, T wave inversion, pathological q-wave
Biochemical markers in blood: troponin and creative kinase

7

Management of angina

Lifestyle advice: stop smoking, increase exercise, diet and weight control
Symptom relief: GTN spray
Reduce number of attacks: beta-blocker/ca channel blocker eg. Diltiazem
Prevention of CVS event: aspirin, statins, ACE-inhibitors

Consider re vascularisation surgery

8

Mechanism of action of GTN spray

A fast acting organic nitrate. Causes venodilation, reduces workload of heart

9

Angina differential diagnosis

Pericarditis
GORD
PE

10

Symptoms of angina

Central/left sided crushing/aching chest pain - brought on by exertion, can radiate to neck/shoulder/arm
Breathlessness
Dizziness

11

Risk factors for IHD

Age, male, family history, smoking, BP, high cholesterol, diabetes, obesity, little exercise