CAD

Question 1

Which treatment of UA/NSTEMI are known to prolong survival?

Answer 1

Beta-blockers, Aspirin, Statin

Question 2

Which patients with unstable angina and NSTEMI need urgent angiography and revascularization? (list two at least)

Answer 2

• heart failure or left ventricular dysfunction
• Hemodynamic instability or cardiogenic shock
• New or worsening mitral regurgitation
• Sustained ventricular arrhythmias
• Recurrent or persistent rest angina

Question 3

What are the goals of STEMI management? List all 5

Answer 3

• relieve pain
• correct abnormal hemodynamics (vital signs)
• initiation of reperfusion therapy
• Antithrombotic therapy to prevent re-thrombosis or acute stent thrombosis
• Beta-blocker therapy to prevent recurrent ischemia & life-threatening ventricular arrhythmias

Question 4

What are the clinical features of vasospastic angina?

Answer 4

• angina symptoms during rest
• symptoms associated with transient ST segment elevation
• they’re triggered by coronary artery vasospasm
• the symptoms happen despite absence of high grade coronary artery stenosis

Question 5

What is the Management of vasospastic angina?

Answer 5

-Smoking cessation
-Long acting nitrates
-Calcium channel blockers
They prevent vasoconstriction & promote vasodilation of coronary

Question 6

How do you differentiate between vasospastic angina from true STEMI?

Answer 6

• Patients are usually younger
• Family history of Prinzmental angina
• few to none cardiovascular risk factors
• Repeat EKG after 15min with total resolution of ST segments