38 Questions
What is Ischemic Heart Disease?
A condition in which there is an imbalance between myocardial oxygen supply and demand
What are the four closely related conditions/syndromes that come under Ischemic Heart Disease?
Angina, acute myocardial infarction, heart failure, and sudden cardiac death
Why does the heart muscle need a constant supply of oxygen?
To function properly
What can happen if myocardial ischemia persists?
It can eventually lead to heart muscle damage and a heart attack
What is a coronary artery anomaly?
A malformation of the coronary arteries that is present from birth
What is coronary artery spasm?
A temporary narrowing of the coronary arteries caused by a sudden contraction of the muscles in the arterial walls
What can trigger coronary artery spasm?
Stress, smoking, or exposure to cold
What is the main cause of Ischemic Heart Disease?
Atherosclerosis of the coronary arteries
What percentage of vessel lumen obstruction is generally considered critical stenosis?
70%-75%
What is the primary cause of unstable angina and infarction?
Abrupt plaque change and thrombosis
What is a major risk factor for developing angina?
All of the above
What is the effect of smoking on the heart?
Damages blood vessels and decreases oxygen supply to the heart
What is the effect of high blood pressure on the arteries?
Damages the inner lining of the arteries
Where is angina typically located?
Behind the breastbone (sternum)
What is the effect of high cholesterol levels on the heart?
Contributes to the development of atherosclerosis
What is a common trigger for angina pain?
Physical exertion or emotional stress
What is the effect of diabetes on blood vessels?
Damage blood vessels
What is a key difference between angina and indigestion or heartburn?
The trigger for the pain
What is the benefit of regular exercise on the heart?
Maintains cardiovascular health and reduces the risk of CAD
What is a non-modifiable risk factor for angina?
Family history
Why are men more susceptible to angina?
The exact reason is unknown
What happens to the risk of angina in women after menopause?
It increases
What is T-wave inversion an abnormal change in?
The shape of the T-wave on the ECG
What is the primary goal of managing angina?
To relieve symptoms, improve quality of life, and reduce the risk of complications
What type of medication is prescribed to reduce the risk of blood clots forming?
Antiplatelet Agents
What is the function of Nitroglycerin?
To relax and widen blood vessels
What is the purpose of Statin medications?
To lower cholesterol levels and reduce the progression of coronary artery disease
What is Percutaneous Coronary Intervention (PCI) commonly known as?
Angioplasty
What is the purpose of Coronary Artery Bypass Grafting (CABG)?
To improve blood flow to the heart muscle
What is Cardiac Rehabilitation?
A program offering supervised exercise, education, and counseling
What type of imaging test uses sound waves to create images of the heart?
Echocardiogram
Which test involves injecting a radioactive tracer into the bloodstream?
Nuclear Stress Test
What is the purpose of a Cardiac CT Scan?
To produce detailed images of the heart and its blood vessels
What is the significance of ST-segment depression on an ECG?
It indicates myocardial ischemia
Which test is considered the gold standard for diagnosing significant coronary artery disease?
Coronary Angiography
What is the purpose of injecting a contrast dye into the coronary arteries during Coronary Angiography?
To provide detailed information about the structure and condition of the coronary arteries
What is the characteristic change seen on an ECG during an angina episode?
ST-segment depression
What is the purpose of an Echocardiogram?
Both a and b
Study Notes
Ischemic Heart Disease
- Ischemic heart disease (IHD) occurs when there is an imbalance between myocardial oxygen supply and demand, leading to myocardial hypoxia and accumulation of waste metabolites.
- Atherosclerosis of the coronary arteries is the most common cause of IHD.
- Four closely related conditions/syndromes that come under IHD are:
- Angina (stable and unstable)
- Acute myocardial infarction (MI)
- Heart failure
- Sudden cardiac death
Causes of Myocardial Ischemia
- Atherosclerotic causes of ischemia:
- Atherosclerosis of the coronary arteries
- Non-atherosclerotic causes of ischemia:
- Coronary artery anomalies (e.g., narrowing, abnormal origin or course of the arteries, or fistulas)
- Coronary artery spasm (temporary narrowing of the coronary arteries caused by a sudden contraction of the muscles in the arterial walls)
Angina Pectoris
- Angina is a condition in which there is a temporary reduction in blood flow to the heart muscle, leading to chest pain or discomfort.
- Angina can be stable (predictable and triggered by physical exertion) or unstable (unpredictable and triggered by emotional stress or other factors).
- Symptoms of angina:
- Chest pain or discomfort (usually located behind the breastbone, but can radiate to the neck, jaw, shoulders, arms, or back)
- Shortness of breath (especially during episodes of chest pain)
- Fatigue (particularly during or after physical activity or stressful situations)
- Indigestion or heartburn (in some cases, angina can be mistaken for indigestion or heartburn)
Risk Factors for Angina Pectoris
- Non-modifiable risk factors:
- Age (especially for men over 45 and women over 55)
- Family history (having a close relative with coronary artery disease)
- Sex (men are generally more susceptible to angina than pre-menopausal women)
- Modifiable risk factors:
- Smoking
- High blood pressure (hypertension)
- High cholesterol levels
- Diabetes
- Obesity
- Sedentary lifestyle
- Stress
Diagnosis of Angina Pectoris
- Imaging tests:
- Echocardiogram (ultrasound test that uses sound waves to create images of the heart)
- Nuclear stress test (uses a radioactive tracer to highlight areas of the heart with reduced blood flow)
- Cardiac CT scan (uses computed tomography to produce detailed images of the heart and its blood vessels)
- Coronary angiography (invasive procedure that involves injecting a contrast dye into the coronary arteries, followed by X-ray imaging)
Management of Angina Pectoris
- Lifestyle modifications:
- Smoking cessation
- Healthy diet
- Regular exercise and weight management
- Pharmacological management:
- Antiplatelet agents (e.g., aspirin or clopidogrel)
- Nitroglycerin
- Beta-blockers
- Calcium channel blockers
- Statins
- Procedures and interventions:
- Percutaneous coronary intervention (PCI) (also known as angioplasty)
- Coronary artery bypass grafting (CABG)
- Cardiac rehabilitation (programs that offer supervised exercise, education, and counseling)
Learn about the pathophysiology of Coronary Artery Disease (CAD) and its effects on the myocardium. Understand the imbalance between myocardial oxygen supply and demand.
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