Cardiovascular disease correct answers Major cause of death in US (CAD most common)
CAD: asymptomatic or chronic stable angina
ACS: unstable angina or MI
CAD risk factors correct answers Modifiable: increase cholesterol, hypertension, diabetes,
obesity, smoking, physical activity
Non-modifiable: gender, race, heredity, age
CAD pathophysiology correct answers Atherosclerosis forms and occludes coronary arteries
unstable angina>myocardial infarction>sudden cardiac death
collateral circulation correct answers circulation by secondary channels after obstruction of
the principal channel supplying the heart
Stable angina correct answers Chest pain associated with physical activity. Relieved by
rest/medicine.
unstable angina correct answers Chest pain that occurs at rest, initial phase of MI
Prinzmetal's Angina correct answers Due to artery spasm, treat with medicine
CAD medical management correct answers Healthy, body weight, diet, physical activity,
smoking cessation, decreased alcohol intake, screening/TX of depression, cardiac rehab
Chronic Stable Angina correct answers History, physical, EKG, stress, test, CT, echo,
troponins, lipids, CK Dash MD
Duration: few minutes, subsides when activity is stopped, sublingual nitro
EKG: ST depression (heart, trying to repolarize)
Chronic stable angina medication correct answers aspirin(short acting, dilates artery/vessels)
sublingual nitro(one tab or 1-2 sprays, relief in five minutes duration 30 to 40 minutes, repeat
every 5 minutesX 3 doses)
Long acting nitrates: decreased frequency of angina, and treat Prinzmetal's angina (headache,
hypertension)
ACE and a RBS: control, blood pressure, vasodilation, decrease blood volume, prevent
ventricular remodeling
B - adrenergic, blockers: decrease myocardial contractility (bradycardia, hypotension,
wheezing, wt gain)
, Calcium channel blockers: systematic, vasodilation, decreased, myocardial, contractility,
vasodilation, decreased HR (fatigue, headache, edema)
Lipid, lowering drugs: statins
Acute Coronary Syndrome correct answers Prolonged ischemia, not reversible
Includes: non-ST elevation (NSTEMI), unstable, angina, ST, depressed due to ischemia, ST
(STEMI) (MI, ST elevated, occlusion, potentially reversible)
T wave inversion correct answers Flipped T waves, meaning, ischemia, repolarization, not
occurring
acute coronary syndrome pathophysiology correct answers Deterioration of plaque, leads to
rupture, aggregation and thrombus
Result: partial occlusion = UA, or NTEMI, total occlusion = STEMI
Unstable angina correct answers Chest pain: new onset occurs at rest, or increase in
frequency/duration, pain lasting >10 min
STEMI &.NSTEMI correct answers STEMI: Emergency, artery opened in 90min with PCI or
thrombolytic
NSTEMI: PCI in 12-72 hours
Acute coronary syndrome manifestations correct answers Severe chest pain with no relief,
heaviness, pressure, tight, burning locations (neck, jaw, arms, back)
often early in the morning, greater than 20 min
release of catecholamines: diaphoresis, increased, HR/BP, vasoconstriction, skin rash,
cool/clammy, increased HR/BP, then decrease BP, decreased renal perfusion, crackles, JVD,
hepatic engorgement, edema, abnormal sound, N/v, fever
dyshrythmia correct answers Most common caused by ischemia, electrolyte imbalances, SNS
stimulation, the VT/VF most common cause of prehospital death, left sided/right sided HF,
cardiogenic shock
Acute Coronary Syndrome Diagnostic studies correct answers Health, history, EKG (changes
in QRS, ST, T-wave), cardiac biomarkers (released after MI) troponins( increase 4-6 hours
after, peek at 10-24 hours return to baseline over 10-14 days
others: CK - NB, myoglobin, BNP (stretching)
PQRST correct answers P: precipitating factors
Q: quality of pain
R: region
S: severity of pain
T: timing