lecture 13

Question 1

define ischaemia

Answer 1

insufficiency in blood supply

Question 2

what is the only source of blood for the heart

Answer 2

coronary arteries

Question 3

what is angina

Answer 3

the chest pain symptoms when the coronary arteries get blocked and reduce blood supply to the heart

Question 4

what imbalance causes angina

Answer 4

imbalance between myocardial blood supply and oxygen demand

Question 5

most common presenting symptom of CAD in women vs men

Answer 5

angina in women , mens first sign is usually a major cardiac event ( MI ) or sudden cardiac death

Question 6

3 types of angina occurrence

Answer 6

atherosclerosis + blood clot
atherosclerosis alone
or a spasm causing the blood vessel to close

Question 7

3 main types of angina

Answer 7

stable, unstable and prinzmetals

Question 8

define stable angina

Answer 8

angina which occurs when coronary perfusion is impaired by fixed/ stable atheroma of coronary arteries - only get symptoms when oxygen demand is increased ( eg exercise)

Question 9

define unstable angina

Answer 9

rapidly worsening chest pain on minimal exertion or at rest - associated with ulcerated atheroma and thrombus formation - producing greater reduction of coronary blood flow to produce angina at rest

Question 10

define prinzmetals angina

Answer 10

spasm of the coronary artery which temporarily narrows the artery causing transient impairment of blood supply - usually occurs at rest

Question 11

in prinzmetals angina - describe the atherosclerotic plaque

Answer 11

probably have some but minor in comparison to pain levels

Question 12

what is exertional/classical angina

Answer 12

only during exercise - due to increased oxygen demand

Question 13

what is anginal equivalent syndrome

Answer 13

caused by myocardial ischemia but symptoms are shortness of breathe or pain which isnt at the chest

Question 14

what is syndrome X

Answer 14

typical exertional angina witha positive exercise stress test

Question 15

whats silent ischemia

Answer 15

ischemia without angina - this is very common

Question 16

what is a holter monitor

Answer 16

portable device for cardiac monitoring - usually for monitoring ECG

Question 17

how long is a holter monitor used for dr to diagnose silent ischaemia

Answer 17

at least 24-72 hours

Question 18

what type of angina only occurs when lying down

Answer 18

decubitus angina

Question 19

what causes decubitus angina

Answer 19

left ventricular function impairment

Question 20

what is nocturnal angina

Answer 20

angina which awakes patients from sleep

Question 21

what is used for classification of angina severity

Answer 21

canadian cardiovascular society grading scale

Question 22

class 1 angina is

Answer 22

angina only during strenuous or prolonged physical activity

Question 23

class 2 angina is

Answer 23

slight limitation, with angina only during vigorous activity

Question 24

class 3 angina is

Answer 24

moderate limitation, symptoms with everyday living activities

Question 25

class 4 angina is

Answer 25

severe limitation, inability to perform any activity without angina or angina st rest

Question 26

what does bruce testing involve and what is the goal of it

Answer 26

goal is to induce a controlled temporoary ischemic stste during clinical and ECG observation. BRUCE involves several stages , with incline and speed increment every 3 minutes

Question 27

what is resting ECG like in between angina attacks

Answer 27

normal - unless theres other problems like MI or LV hypertrophy

Question 28

define unstable angina

Answer 28

angina at rest which doesnt respons to therapy. cab ve indicator of impending MI

Question 29

what causes plawues to rupture

Answer 29

either plaque vulnerability or external stresses which trigger them to rupture

Question 30

treatment options for stable angina