Coronary Artery Disease and ACS Overview
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Questions and Answers

What is the primary cause of Coronary Artery Disease (CAD)?

  • Nutritional deficiencies
  • Atherosclerosis (correct)
  • Coronary vasospasm
  • Increased physical activity

    • Which type of angina is characterized by a regular pattern of symptoms?

  • Acute Coronary Syndrome
  • Unstable Angina
  • Variant Angina
  • Stable Angina (correct)

    • What distinguishes NSTEMI from Unstable Angina?

  • Type of treatment required
  • Duration of symptoms
  • Presence of chest pain
  • Presence of serum biomarkers (correct)

    • Which symptom is most commonly associated with an acute myocardial infarction (MI)?

    <p>Severe, crushing chest pain</p> Signup and view all the answers

    What is the gold standard treatment for opening occluded coronary vessels?

    <p>Cardiac catheterization</p> Signup and view all the answers

    Which type of angina is often triggered by exertion or emotional stress?

    <p>Chronic Stable Angina</p> Signup and view all the answers

    What physiological changes occur in response to increased demand for oxygen due to stress?

    <p>Increased sympathetic nervous system activity</p> Signup and view all the answers

    In the context of CAD, what does ischemia refer to?

    <p>Lack of oxygen being delivered to heart tissue</p> Signup and view all the answers

    Which type of angina occurs at night and is often associated with migraines?

    <p>Variant angina</p> Signup and view all the answers

    What is the main characteristic of Heart Failure with preserved Ejection Fraction (HFpEF)?

    <p>Impaired filling and relaxation of the heart</p> Signup and view all the answers

    Which diagnostic measure is NOT typically used to assess heart failure?

    <p>CBF values</p> Signup and view all the answers

    What is a common cause of Right Ventricular Heart Failure?

    <p>Pulmonary hypertension</p> Signup and view all the answers

    Which treatment is primarily used to manage heart failure?

    <p>Beta blockers</p> Signup and view all the answers

    In the equation for calculating Left Ventricular Ejection Fraction (LVEF), which variables are involved?

    <p>End-Diastolic Volume and End-Systolic Volume</p> Signup and view all the answers

    What symptom is included in the mnemonic 'FACES' related to heart failure?

    <p>Chest congestion</p> Signup and view all the answers

    Which factor decreases Stroke Volume as part of heart failure diagnostics?

    <p>Reduced contractility</p> Signup and view all the answers

    What typically occurs after a major adverse cardiovascular event (MACE) in relation to heart failure?

    <p>Heart remodeling leads to compensation</p> Signup and view all the answers

    What imaging test is commonly used to visualize heart structures in diagnosing heart conditions?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the characteristic feature of Unstable Angina?

    <p>New onset of severe chest pain</p> Signup and view all the answers

    Which symptom is least likely to be associated with Chronic Ischemic Heart Disease (IHD)?

    <p>Severe, radiating pain</p> Signup and view all the answers

    What differentiates NSTEMI from STEMI?

    <p>Presence of serum biomarkers</p> Signup and view all the answers

    Which trigger is commonly associated with an increase in myocardial oxygen demand?

    <p>Emotional stress</p> Signup and view all the answers

    What is a common symptom of a Myocardial Infarction (MI)?

    <p>Persistent pain that does not subside</p> Signup and view all the answers

    During what time frame are most cases of Chronic Ischemic Heart Disease (IHD) typically observed?

    <p>In the early morning hours</p> Signup and view all the answers

    What types of biomarkers are typically monitored in NSTEMI?

    <p>Troponin and CK-MB levels</p> Signup and view all the answers

    Which of the following is not a significant factor contributing to the development of Atherosclerosis?

    <p>Increased fluid intake</p> Signup and view all the answers

    What is the primary characteristic of silent myocardial ischemia?

    <p>Absence of angina despite impaired blood flow</p> Signup and view all the answers

    Which condition is primarily associated with heart failure with reduced ejection fraction (HFrEF)?

    <p>LVEF below 40%</p> Signup and view all the answers

    What diagnostic method can be used to assess heart failure symptoms and function?

    <p>Exercise Stress Test</p> Signup and view all the answers

    In the context of heart failure, what does a reduction in preload indicate?

    <p>Decreased stroke volume due to stiff heart muscle</p> Signup and view all the answers

    Which of the following treatments is often included for managing heart failure?

    <p>Beta blockers</p> Signup and view all the answers

    Which factor is a common cause leading to left ventricular heart failure?

    <p>Mitral valve disease</p> Signup and view all the answers

    What physiological change characterizes right ventricular heart failure?

    <p>Peripheral tissue congestion</p> Signup and view all the answers

    What does the formula for calculating stroke volume (SV = EDV - ESV) represent?

    <p>Volume of blood ejected with each heartbeat</p> Signup and view all the answers

    Which complication may arise following a major adverse cardiovascular event (MACE)?

    <p>Increased heart remodeling</p> Signup and view all the answers

    What does the mnemonic 'FACES' help identify in heart failure patients?

    <p>Symptoms of heart failure</p> Signup and view all the answers

    What is one potential risk factor for silent myocardial ischemia?

    <p>Hypertension</p> Signup and view all the answers

    Which treatment option is usually not recommended for managing heart failure?

    <p>Anticoagulants</p> Signup and view all the answers

    What diagnostic tool is useful for assessing cardiac function in heart failure patients?

    <p>Echocardiogram</p> Signup and view all the answers

    Which of the following symptoms is associated with left ventricular heart failure?

    <p>Pulmonary edema</p> Signup and view all the answers

    What does decreased preload in heart failure indicate?

    <p>Inadequate ventricular filling</p> Signup and view all the answers

    Which type of angina is typically associated with vasospasm?

    <p>Variant angina</p> Signup and view all the answers

    What is a common consequence of right ventricular heart failure?

    <p>Congestion of peripheral tissues</p> Signup and view all the answers

    Which of the following best describes heart failure with preserved ejection fraction (HFpEF)?

    <p>Normal percentage of blood flow</p> Signup and view all the answers

    Which type of angina is characterized by a coronary vasospasm?

    <p>Variant Angina</p> Signup and view all the answers

    What is indicated by the presence of serum biomarkers in NSTEMI?

    <p>Acute Coronary Syndrome</p> Signup and view all the answers

    What happens to stroke volume in a heart experiencing increased afterload?

    <p>It decreases as the heart struggles to contract</p> Signup and view all the answers

    Which symptom is least characteristic of an acute myocardial infarction (MI)?

    <p>Severe and sudden onset dizziness</p> Signup and view all the answers

    What is a significant determinant of cardiac output in heart failure?

    <p>Heart rate</p> Signup and view all the answers

    What does ischemic death refer to in the context of myocardial infarction?

    <p>Loss of heart muscle due to lack of oxygen</p> Signup and view all the answers

    What is the defining characteristic of STEMI?

    <p>Presence of ST segment elevation on ECG</p> Signup and view all the answers

    Which type of angina occurs in response to a predictable trigger such as stress or exercise?

    <p>Chronic Stable Angina</p> Signup and view all the answers

    What is a common physiological response to increased oxygen demand due to stress?

    <p>Increased SNS activity</p> Signup and view all the answers

    Which of the following symptoms is associated with both Acute Coronary Syndrome and Chronic Ischemic Heart Disease?

    <p>Sweating</p> Signup and view all the answers

    What triggers can lead to an increase in myocardial oxygen demand?

    <p>Stress and exercise</p> Signup and view all the answers

    How are the symptoms of Chronic Ischemic Heart Disease typically manifested?

    <p>Through recurring episodes of chest pain over time</p> Signup and view all the answers

    Match the type of angina with its characteristics:

    <p>Exertional Angina = Relieved by rest and nitrates Silent Myocardial Ischemia = Absence of angina Variant Angina = Occurs at night Emotional Stress Angina = Triggered by stress</p> Signup and view all the answers

    Match the heart failure type with its details:

    <p>HFrEF = Dilated ventricles, reduced stroke volume HFpEF = LVEF &gt; 50% Right Ventricular Heart Failure = Caused by pulmonary hypertension Left Ventricular Heart Failure = Caused by myocardial infarction</p> Signup and view all the answers

    Match the diagnostic methods with their use:

    <p>Echocardiogram = Visualizes heart structures Exercise Stress Test = Assesses physical endurance related to heart function Cardiac Cath = Directly evaluates coronary arteries Blood Test = Measures biomarkers like BNP</p> Signup and view all the answers

    Match the treatment options with their purpose:

    <p>Statins = Reduce cholesterol levels Beta Blockers = Decrease heart rate and workload Percutaneous Coronary Intervention = Opens occluded coronary vessels Coronary Artery Bypass Graft = Redirects blood flow around blocked arteries</p> Signup and view all the answers

    Match the symptoms of heart failure with their descriptions:

    <p>Fatigue = General tiredness and weakness Chest congestion = Feeling of tightness in the chest Edema = Swelling due to fluid retention Shortness of breath = Difficulty in breathing during activity</p> Signup and view all the answers

    Match the determinants of cardiac output with their definitions:

    <p>Stroke Volume = Amount of blood pumped per beat Heart Rate = Number of beats per minute Preload = Initial stretching of the cardiac muscle Afterload = Resistance the heart must overcome to pump blood</p> Signup and view all the answers

    Match the conditions leading to heart failure with their causes:

    <p>Hypertension = Increased pressure on vessel walls Diabetes = Increased risk of coronary artery disease Obesity = Excess body weight affects heart function Arrhythmias = Irregular heart rhythms disrupting blood flow</p> Signup and view all the answers

    Match the physiological changes in heart failure with their effects:

    <p>Decreased Cardiac Output = Inadequate blood circulation Increased Afterload = Ventricle works harder to eject blood Decreased Preload = Heart can't fill properly Contractility Reduction = Weakened heart contractions</p> Signup and view all the answers

    Match the components of the LVEF formula with their meanings:

    <p>EDV = End-Diastolic Volume ESV = End-Systolic Volume LVEF = Left Ventricular Ejection Fraction SV = Stroke Volume</p> Signup and view all the answers

    Match the causes of Right Ventricular Heart Failure with their effects:

    <p>Valve disease = Disrupts normal blood flow Pulmonary hypertension = Increases pressure on the right ventricle Congestion of peripheral tissues = Fluid buildup in legs and abdomen GI tract congestion = Affects digestion and absorption</p> Signup and view all the answers

    Match the type of angina with its description:

    <p>Stable Angina = Regular pattern of symptoms Unstable Angina = New onset chest pain not lasting longer than 20 minutes Variant Angina = Caused by coronary vasospasm Chronic Stable Angina = Fixed coronary obstruction causing supply-demand mismatch</p> Signup and view all the answers

    Match the type of myocardial infarction with its characteristics:

    <p>NSTEMI = Serum biomarkers are present, partial occlusion STEMI = Complete occlusion with significant damage Unstable Angina = No biomarkers present, severe new onset chest pain Myocardial Infarction = Acute plaque disruption leading to ischemic death</p> Signup and view all the answers

    Match the symptom with its corresponding condition:

    <p>Dyspnea = Common in acute myocardial infarction Dizziness = Associated with unstable angina Palpitations = Common in chronic ischemic heart disease Sweating = Occurs in acute coronary syndrome</p> Signup and view all the answers

    Match the treatment to its purpose:

    <p>Cardiac catheterization = To open blocked vessels Medications = To manage angina symptoms Lifestyle changes = To reduce atherosclerosis progression Stress management = To decrease oxygen demand</p> Signup and view all the answers

    Match the biomarker to its relevance in myocardial infarction:

    <p>Troponin = Rises within an hour and can remain elevated Creatinine kinase -MB = Indicator of myocardial injury C-reactive protein = Not specific for myocardial injury B-type natriuretic peptide = Used in heart failure diagnosis</p> Signup and view all the answers

    Match the term with its definition:

    <p>Ischemia = Lack of oxygen to the heart tissue Occlusion = Blockage of blood flow in coronary arteries Atherosclerosis = Plaque buildup in arteries Myocardial Infarction = Tissue death due to prolonged ischemia</p> Signup and view all the answers

    Match the symptom with the type of angina:

    <p>Chest pain = Common to all types of angina Pain at rest = Typically seen in unstable angina Predictable chest pain = Characteristic of stable angina Recurrent episodes = Seen in chronic stable angina</p> Signup and view all the answers

    Match the acute coronary syndrome type with its description:

    <p>NSTEMI = Characterized by ST segment depression STEMI = Characterized by ST segment elevation Unstable Angina = Chest pain without biomarkers Myocardial Infarction = Tissue death due to coronary artery blockage</p> Signup and view all the answers

    Match the risk factor with its description:

    <p>Atherosclerosis = Most common cause of CAD Vasospasm = Can trigger variant angina Thrombosis = Blood clot formation leading to blockage Stress = Increases oxygen demand on the heart</p> Signup and view all the answers

    Match the condition to the symptom primarily associated with it:

    <p>Chronic Ischemic Heart Disease = Accumulated myocardial ischemia leading to CHF Acute Coronary Syndrome = Severe chest pain Heart failure = Dyspnea Myocardial Infarction = Crushing pain radiating to left arm</p> Signup and view all the answers

    Study Notes

    Coronary Artery Disease (CAD)

    • Most common cause: Atherosclerosis, reducing oxygen-rich blood flow (ischemia).
    • Plaque buildup: Increases risk of blood clots.
    • Types:
      • Acute Coronary Syndrome (ACS)
      • Chronic Ischemic Heart Disease (IHD)
    • Symptoms (general): Angina (chest pain), dizziness, nausea, palpitations, rapid heartbeat, sweating, shortness of breath, weakness.

    Acute Coronary Syndrome (ACS)

    • Cause: Acute plaque disruption.
    • Clinical syndrome: Often involves myocardial infarction (MI).
    • Types:
      • Unstable angina: No serum biomarkers, new or worsening chest pain (not lasting >20 minutes), rule out indigestion, onset outside past month.
      • NSTEMI (Non-ST Elevation Myocardial Infarction): Serum biomarkers (troponin) present, ECG shows ST depression or T wave inversion. Partial/temporary coronary occlusion, less heart damage.
      • STEMI (ST Elevation Myocardial Infarction): One or more major arteries blocked (thrombi), causing ischemic tissue death (necrosis). Severity impacted by occlusion location, affected area, and time to reperfusion. Symptoms include severe, crushing, radiating pain, constricting chest pain not relieved by nitroglycerin, dyspnea, lightheadedness, sweating, fatigue. Necrosis determined by location/area affected, time to reperfusion.
    • Biomarkers:
      • Creatinine kinase-MB (CK-MB)
      • Troponin (rises within an hour, elevated for 7-10 days).

    Chronic Ischemic Heart Disease (IHD)

    • Cause: Accumulated myocardial ischemia, progressing to heart failure.
    • Triggers: Reduced blood flow (atherosclerosis, vasospasm, thrombosis), increased oxygen demand (stress, exertion).
    • Body's response: Sympathetic nervous system activation, rising blood pressure and heart rate, increased contractility.
    • Frequency: Often occurs in the first hours of waking.
    • Types:
      • Chronic Stable Angina: Fixed coronary obstruction, mismatch between demand and blood supply, exertional/emotional stress-related pain, relieved with rest and nitroglycerin.
      • Silent Myocardial Ischemia: Common in women, absence of angina, impaired blood flow due to atherosclerosis/vasospasm, related to comorbidities (diabetes, neuropathy, old age).
      • Variant (vasospastic) angina: Nighttime onset, associated with migraines, Raynaud's, occurs at rest.
    • Diagnosis: Echocardiogram, ECG, exercise stress test, CT, MRI.
    • Treatment: Statins, beta-blockers, percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG). Lifestyle modifications.

    Heart Failure

    • Definition: Inability of the heart to maintain sufficient cardiac output to meet the body's needs.
    • Types:
      • HFrEF (Heart Failure with Reduced Ejection Fraction): Systolic dysfunction (contraction/ejection), ejection fraction < 40%. Commonly after MI, dilated ventricles, reduced stroke volume, increased end-diastolic and end-systolic volumes.
      • HFpEF (Heart Failure with Preserved Ejection Fraction): Diastolic dysfunction (filling/relaxing), ejection fraction > 50%. Often due to persistent comorbidities (hypertension, diabetes, obesity), normal pumping percentage, reduced preload, reduced stroke volume.
    • Causes: CAD, AMI, cardiomyopathy, congenital heart disease, hypertension, diabetes, arrhythmias, kidney disease, obesity.
    • Determinants of Heart Failure: Decreased cardiac output; decreased stroke volume (preload, afterload, contractility); decreased preload (inadequate filling); increased afterload (ventricle works harder); impaired contractility.
      • Cardiac output (CO) = Stroke volume (SV) x Heart rate (HR)
      • Ejection fraction (LVEF) = [(End-diastolic volume - End-systolic volume) / End-diastolic volume] x 100.
    • Right Ventricular Heart Failure: Pulmonary hypertension, tricuspid/pulmonary valve disease, peripheral tissue congestion, liver congestion, GI congestion.
    • Left Ventricular Heart Failure: Hypertension, aortic/mitral valve disease, MI, decreased cardiac output, pulmonary congestion, pulmonary edema. Impaired gas exchange

    Symptoms of Heart Failure (FACES):

    • Fatigue
    • Activities limited
    • Chest congestion
    • Edema
    • Shortness of breath

    Diagnosing Heart Failure

    • Auscultation
    • Echocardiogram
    • Exercise stress test (6-minute walk, treadmill)
    • EKG
    • Cardiac catheterization
    • Blood tests (cTnl, Angiotensin II, ANP, BNP)

    Treatment of Heart Failure

    Lifestyle modifications, neurohormonal modulators, statins, beta-blockers, SGLT2 inhibitors, device therapy (pacemaker), PCI or structural repair (stent), advanced heart assist devices or transplant.

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    Description

    This quiz covers essential information about Coronary Artery Disease (CAD) and Acute Coronary Syndrome (ACS). It delves into their causes, symptoms, and the different types of ACS, including unstable angina, NSTEMI, and STEMI. Test your knowledge on these cardiovascular conditions and their implications.

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