Coronary Artery Disease & Acute Coronary Syndromes
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Questions and Answers

Which of the following is NOT a cause of Coronary Artery Disease (CAD)?

  • Diabetes
  • Low blood pressure (Hypotension) (correct)
  • High blood pressure (Hypertension)
  • High cholesterol (Dyslipidemia)

    • Coronary artery disease is the leading cause of death for both men and women in the United States.

    True (A)

    Match the following types of angina to their descriptions:

    Stable Angina = Chest pain that occurs during exertion and subsides with rest Unstable Angina = Chest pain that occurs at rest or with minimal exertion Vasospastic Angina = Chest pain that occurs due to spasms in coronary arteries

    What are three factors that have contributed to the decline in the incidence of coronary artery disease?

    <p>Improved identification and treatment of hypertension and dyslipidemia, education on early signs of myocardial infarction, and better management of metabolic diseases.</p> Signup and view all the answers

    Which of the following is NOT a common manifestation of unstable angina?

    <p>Pain is always relieved by nitroglycerin or rest (C)</p> Signup and view all the answers

    ST-segment elevation myocardial infarction (STEMI) is a medical emergency and requires immediate intervention.

    <p>True (A)</p> Signup and view all the answers

    What are the two main types of myocardial infarction?

    <p>ST-elevation MI (STEMI) and non-ST elevation MI (NSTEMI)</p> Signup and view all the answers

    The acronym "MONA" stands for __________, __________, __________, and __________.

    <p>Morphine, Oxygen, Nitrates, Aspirin</p> Signup and view all the answers

    Match the following cardiac enzymes with their normal values:

    <p>Troponin T = &lt; 0.1 ng/mL Troponin I = &lt; 0.04 ng/mL</p> Signup and view all the answers

    Which of the following is a common complication after cardiac catheterization?

    <p>All of the above (D)</p> Signup and view all the answers

    Thrombolytics are always the primary treatment for STEMI.

    <p>False (B)</p> Signup and view all the answers

    What is the primary goal of percutaneous coronary intervention (PCI)?

    <p>To open blocked coronary arteries and improve blood flow to the heart muscle</p> Signup and view all the answers

    The ______ is used to determine the location and extent of coronary artery disease during a cardiac catheterization procedure.

    <p>contrast dye</p> Signup and view all the answers

    Which of the following is NOT a medication used in the management of myocardial infarction?

    <p>Insulin (C)</p> Signup and view all the answers

    Aspirin is given to patients with STEMI to prevent further platelet aggregation and thrombus formation.

    <p>True (A)</p> Signup and view all the answers

    What is the time frame for administering thrombolytic agents to patients with STEMI?

    <p>Within 6-12 hours after the onset of symptoms</p> Signup and view all the answers

    The ______ is a device used during cardiac catheterization to close the access site and prevent bleeding.

    <p>vascular closure device</p> Signup and view all the answers

    Which of the following is a core measure for the management of acute myocardial infarction?

    <p>All of the above (D)</p> Signup and view all the answers

    Patients undergoing cardiac catheterization require bedrest for 2-6 hours after the procedure.

    <p>True (A)</p> Signup and view all the answers

    Flashcards

    Coronary Artery Disease (CAD)

    A disease of the coronary arteries leading to reduced blood flow to the heart.

    Acute Coronary Syndromes (ACS)

    A group of conditions including unstable angina and myocardial infarction.

    Chronic Stable Angina

    Chest pain that occurs in a predictable pattern with activity or stress.

    Unstable Angina

    Chest pain that occurs at rest or with increasing frequency and intensity.

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    Myocardial Infarction

    Commonly known as a heart attack, occurs when blood flow to a part of the heart is blocked.

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    CAD/CVD

    Coronary Artery Disease/Cardiovascular Disease affecting heart and blood vessels.

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    Atherosclerosis

    A condition where plaque builds up in arteries, restricting blood flow.

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    Ischemia

    Reduced blood flow to tissues, causing a shortage of oxygen.

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    Myocardial Infarction (MI)

    Severe deprivation of oxygen to myocardial tissue, leading to tissue death.

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    ST-Elevation MI (STEMI)

    A type of MI characterized by ST segment elevation on EKG, typically indicates a full blockage.

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    Non-ST Elevation MI (NSTEMI)

    A type of MI without ST elevation on EKG; may show ST depression or T-wave inversion.

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    Cardiac Catheterization

    A procedure used to diagnose and treat issues in the coronary arteries.

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    MONA

    A protocol for managing chest pain: Morphine, Oxygen, Nitroglycerin, Aspirin.

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    Troponin

    Types T and I are cardiac enzymes; markers for heart muscle injury.

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    Plaque Rupture

    When plaque in the arteries breaks open, leading to thrombus formation and possible infarction.

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    Emergent Interventions

    Immediate actions taken for life-threatening symptoms like MI.

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    Thrombolytics

    Medications that dissolve blood clots in arteries during an MI.

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    Post-Catheterization Care

    Aftercare procedures to monitor and prevent complications after heart catheterization.

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    Angina

    Chest pain caused by reduced blood flow to the heart muscle, often due to coronary artery disease.

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    Heart Function Tests

    Tests like EKG or blood tests to assess heart health post-MI.

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    Study Notes

    Coronary Artery Disease (CAD) & Acute Coronary Syndromes (ACS)

    • CAD is the leading cause of death in men and women in the US, although its incidence is decreasing due to improved hypertension and dyslipidemia treatment, education, and metabolic disease management.
    • CAD is categorized as chronic stable angina, acute coronary syndromes (unstable angina, new-onset angina, vasospastic angina, myocardial infarction), almost half of non-Hispanic Black adults have some form of CAD/CVD.

    Pathophysiology of CAD

    • CAD is caused by atherosclerosis in the coronary arteries.
    • Plaque buildup narrows the arteries, reducing blood flow to the heart muscle, causing angina.
    • Plaque rupture can completely block an artery, leading to myocardial ischemia or infarction.

    Diagnostic Tests for CAD/ACS

    • Cardiac Enzymes: Troponin T or I, elevated levels indicate myocardial damage.
    • Coagulation Studies: PT/INR and aPTT/PTT assess blood clotting.

    Acute Coronary Syndromes (ACS)

    • Unstable Angina: Chest pain with rest or exertion, increasing frequency, intensity, and duration; not relieved by nitroglycerin or rest
    • Myocardial Infarction (MI): Severe oxygen deprivation to the heart muscle, leading to tissue injury and necrosis. Two types:
      • ST-Elevation Myocardial Infarction (STEMI): Medical emergency, involves ST segment elevation and/or T-wave inversion on a 12-lead EKG, troponins elevate, rapid intervention is needed (within 4-6 hours of symptom onset). Rupture of atherosclerotic plaque triggers platelet aggregation and thrombus formation. This type needs immediate treatment, such as cardiac catheterization.
      • Non-ST Elevation Myocardial Infarction (NSTEMI): Associated with ST segment depression and/or T-wave inversion on a 12-lead EKG; troponins are initially normal but rise over 3-12 hours. Causes could be coronary vasospasm, spontaneous coronary artery dissection, or sluggish blood flow due to CAD.

    Manifestations of MI

    • Chest Pain: Sudden, severe, crushing, pressure mid-sternal or sub-sternal, radiating to the back, jaw, left or right arm; not relieved by nitroglycerin or rest.
    • Dyspnea: Shortness of breath
    • Indigestion, nausea/vomiting, diaphoresis: Symptoms often experienced with heart attack
    • Denial: Patients may deny the severity and implications of the situation.

    Emergency Interventions for MI

    • MONA: Monitoring, Oxygen, Nitroglycerin, Aspirin; along with other treatments
    • Cardiac Catheterization: To determine the location and extent of CAD. Includes PCI (Percutaneous Coronary Intervention) or PTCA (Percutaneous Transluminal Coronary Angioplasty).
    • Thrombolytics: "Clot busters" used as primary treatment if PCI or surgery is unavailable; must be given within 6-12 hours of STEMI onset. Careful monitoring for bleeding risk is crucial.

    Post-Catheterization

    • Complications: Hematoma, retroperitoneal bleed, loss of pulse, pseudoaneurysm, allergic reactions to dye or medication, arrhythmias, and reocclusion/restenosis.
    • Care: Bedrest (2-6 hours), supine position, protecting the groin or radial access site; monitoring vital signs and extremity pulses; monitoring urinary output (due to contrast dye).

    Medical Management of MI

    • Oxygen, Nitrates, Morphine (Emergency), Beta-Blockers, ACE Inhibitors, Antiplatelets, Anticoagulants: Medications often employed to manage MIs.
    • Cholesterol-Lowering Agents: Prescribed to address LDL levels exceeding 100.

    AMI Core Measures

    • Aims for consistent adherence to standardized procedures and guidelines following a heart attack. The guidelines include aspirin administration, beta-blocker prescriptions, PCI within 90 minutes (now aiming for 60 minutes) to alleviate heart attacks, fibrinolytic use, LDL and cholesterol-lowering medication prescription, and left ventricular (LV) function assessment and ACE inhibitor prescription.

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    Description

    This quiz covers key aspects of Coronary Artery Disease (CAD) and Acute Coronary Syndromes (ACS), including their definitions, pathophysiology, and diagnostic tests. Learn about the impact of CAD on health and the importance of recognizing symptoms associated with these conditions.

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