Stable Ischemic Heart Disease Treatment Quiz
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Questions and Answers

Which of the following is NOT a risk factor for stable ischemic heart disease (SIHD) as mentioned in the text?

  • Hypotension (correct)
  • Obesity
  • High cholesterol levels
  • Smoking

During a cardiac stress test, which of the following is used to increase myocardial oxygen demand?

  • High-calorie diet
  • Smoking
  • Intravenous medications (correct)
  • Reduced physical activity

What is the recommended waist circumference for males to maintain as part of non-drug treatment for stable ischemic heart disease?

  • Less than 30 inches
  • Less than 45 inches
  • Less than 40 inches (correct)
  • Less than 35 inches

How many minutes of moderate-intensity aerobic activity per day are recommended for patients as part of non-drug treatment for stable ischemic heart disease?

<p>30 - 60 minutes (A)</p> Signup and view all the answers

Which formulation of nitroglycerin should be used for fast relief of angina?

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

What is the recommended dose for short-acting nitrates?

<p>0.4 mg (A)</p> Signup and view all the answers

Which medication can selectively inhibit the late phase Na current and decrease intracellular Ca?

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

What is the primary contraindication for ranolazine?

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

What is the main purpose of long-acting nitrates when used with beta-blockers?

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

What is the most common side effect of nitrates?

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

How should long-acting nitrate patches be administered?

<p>Wear on for 12-14 hours, off for 10-12 hours (A)</p> Signup and view all the answers

Which type of nitrates require a 10-12 hour nitrate-free interval to reduce tolerance?

<p>Long-acting nitrates (C)</p> Signup and view all the answers

What is the recommended alcohol intake limit for men with stable ischemic heart disease?

<p>2 drinks/day (B)</p> Signup and view all the answers

Which drug is recommended as the first-line antiplatelet for stable ischemic heart disease?

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

What is the first-line treatment for antianginal therapy in stable ischemic heart disease?

<p>Beta-blockers (D)</p> Signup and view all the answers

What is the FDA-approved combination to reduce the risk of cardiovascular events in stable ischemic heart disease?

<p>Low-dose rivaroxaban with aspirin (A)</p> Signup and view all the answers

What is the recommended annual vaccination for patients with stable ischemic heart disease?

<p>Influenza vaccine (D)</p> Signup and view all the answers

Which condition should be aggressively managed with guideline-recommended treatments in stable ischemic heart disease?

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

When is clopidogrel used in stable ischemic heart disease?

<p>When there is a contraindication to aspirin (B)</p> Signup and view all the answers

What is the recommended limit for alcohol intake for women with stable ischemic heart disease?

<p>1 drink/day (C)</p> Signup and view all the answers

Which drug regimen is used together to achieve treatment goals in stable ischemic heart disease?

<p>Antiplatelet and antianginal (D)</p> Signup and view all the answers

What type of statin treatment is recommended for patients with stable ischemic heart disease?

<p>High-intensity (B)</p> Signup and view all the answers

What is the FDA-approved combination to reduce the risk of cardiovascular events in stable ischemic heart disease?

<p>Low-dose rivaroxaban with aspirin (B)</p> Signup and view all the answers

What is recommended for patients who smoke and have stable ischemic heart disease?

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

Stable Ischemic Heart Disease (SIHD) is primarily diagnosed through coronary angiography

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

The recommended waist circumference for females to maintain as part of non-drug treatment for SIHD is < 35 inches

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

The cardiac stress test can be performed using either exercise or intravenous medications to increase myocardial oxygen demand

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

Patients with SIHD should engage in 30 - 60 minutes of moderate-intensity aerobic activity 3 - 4 days per week

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

Short-acting nitrates are used for immediate relief of chest pain, while long-acting nitrates are used for prevention and management of stable ischemic heart disease.

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

Ranolazine can cause QT prolongation, therefore caution is advised when using it.

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

Long-acting nitrates require a 10-12 hour nitrate-free interval to prevent tolerance.

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

Nitrates reduce myocardial oxygen demand by increasing blood flow through collateral (non-atherosclerotic) arteries.

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

Nitrates can cause tachyphylaxis, which is a reduced effectiveness or tolerance with long-acting products.

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

Ranolazine is recommended for acute treatment of chest pain.

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

Nitrates have little to no clinical effects on heart rate or blood pressure.

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

Short-acting nitrates, such as Nitroglycerin SL tablet, should be stored in the original amber glass bottle.

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

Cardiac rehabilitation is not encouraged for at-risk patients at first diagnosis of stable ischemic heart disease

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

There is no recommended limit for alcohol intake for women with stable ischemic heart disease

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

High-intensity statin treatment is not recommended for patients with stable ischemic heart disease

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

Hypertension, heart failure, and diabetes should not be aggressively managed with guideline-recommended treatments for stable ischemic heart disease

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

Beta-blockers are not the first line for antianginal treatment in stable ischemic heart disease

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

Aspirin is not the recommended antiplatelet for stable ischemic heart disease

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

Low-dose rivaroxaban in combination with aspirin is not FDA-approved to reduce the risk of cardiovascular events in stable ischemic heart disease

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

Annual influenza vaccine is not recommended for patients with stable ischemic heart disease

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

Smoking cessation is not recommended for patients with stable ischemic heart disease

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

Aspirin and clopidogrel do not have specific dosing, warnings, and side effects that should be monitored for potential drug interactions

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

Patients with stable ischemic heart disease do not need to limit alcohol intake to 1 - 2 drinks/day for men

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

Antiplatelet and antianginal drug regimens are not used together to achieve treatment goals in stable ischemic heart disease

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

What are the risk factors for stable ischemic heart disease (SIHD) mentioned in the text?

<p>Hypertension, smoking, dyslipidemia, diabetes, obesity, and physical inactivity</p> Signup and view all the answers

How is the likelihood of coronary artery disease (CAD) and stable ischemic heart disease (SIHD) diagnosed?

<p>Through a cardiac stress test, which increases myocardial oxygen demand with either exercise or intravenous medications and monitors for symptoms, heart rate and blood pressure changes, transient rhythm disturbances, or ST segment abnormalities on an ECG</p> Signup and view all the answers

What non-drug treatments are recommended for patients with stable ischemic heart disease?

<p>Following a heart healthy diet, maintaining a healthy BMI and waist circumference, and engaging in 30-60 minutes of moderate-intensity aerobic activity 5-7 days per week, supplemented by an increase in daily lifestyle activities</p> Signup and view all the answers

When the diagnosis of stable ischemic heart disease (SIHD) is certain, what further assessment can be performed?

<p>Coronary angiography to assess the extent of atherosclerosis and need for revascularization</p> Signup and view all the answers

What is the primary purpose of long-acting nitrates when used with beta-blockers?

<p>To prevent and manage stable ischemic heart disease by reducing myocardial oxygen demand and increasing blood flow through collateral (non-atherosclerotic) arteries.</p> Signup and view all the answers

What are the contraindications for using ranolazine?

<p>Liver cirrhosis and do not use with strong CYP3A4 inhibitors or inducers.</p> Signup and view all the answers

How does ranolazine decrease myocardial oxygen demand?

<p>Ranolazine selectively inhibits the late phase Na current and decreases intracellular Ca, which can decrease myocardial oxygen demand by decreasing ventricular tension and oxygen consumption.</p> Signup and view all the answers

What is the most common dose for short-acting nitrates?

<p>0.4 mg</p> Signup and view all the answers

What are the common side effects of nitrates?

<p>Headache, flushing, syncope</p> Signup and view all the answers

What is the recommendation for storing nitroglycerin SL tablets?

<p>Store nitroglycerin SL tablets in the original amber glass bottle.</p> Signup and view all the answers

What is the FDA-approved use for ranolazine?

<p>Ranolazine is not for acute treatment of chest pain.</p> Signup and view all the answers

Why are DHPs preferred when CCBs are used in combination with beta-blockers?

<p>Due to the risk of excessive bradycardia when non-DHPs are used with beta-blockers.</p> Signup and view all the answers

What are the treatment goals for Stable Ischemic Heart Disease (SIHD)?

<p>The treatment goals for SIHD are to improve function, prevent future cardiovascular events, and reduce the risk of cardiovascular death</p> Signup and view all the answers

What is the recommended limit for alcohol intake for men with SIHD?

<p>1 - 2 drinks/day</p> Signup and view all the answers

Which antiplatelet is recommended for SIHD, and when is clopidogrel used?

<p>Aspirin is the recommended antiplatelet, and clopidogrel is used when there is a contraindication to aspirin</p> Signup and view all the answers

What is the first-line treatment for antianginal therapy in SIHD?

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

What type of statin treatment is recommended for patients with SIHD?

<p>High-intensity statin treatment</p> Signup and view all the answers

How should alcohol intake be managed for patients with SIHD?

<p>Alcohol intake should be limited to 1 drink/day for women and 1 - 2 drinks/day for men</p> Signup and view all the answers

What is the FDA-approved combination to reduce the risk of cardiovascular events in SIHD?

<p>Low-dose rivaroxaban in combination with aspirin</p> Signup and view all the answers

What are the recommended ways to manage hypertension, heart failure, and diabetes in SIHD?

<p>Hypertension, heart failure, and diabetes should be aggressively managed with guideline-recommended treatments</p> Signup and view all the answers

What is the recommended annual vaccination for patients with SIHD?

<p>Annual influenza vaccine</p> Signup and view all the answers

What is the main purpose of long-acting nitrates when used with beta-blockers?

<p>Prevention and management of stable ischemic heart disease</p> Signup and view all the answers

What is the recommended medication for antianginal treatment after beta-blockers?

<p>Calcium channel blockers and long-acting nitrates</p> Signup and view all the answers

What is the impact of smoking on patients with SIHD?

<p>Patients who smoke should quit, and secondhand smoke should be avoided</p> Signup and view all the answers

Study Notes

Treatment Approach for Stable Ischemic Heart Disease

  • Medically supervised programs, such as cardiac rehabilitation, are encouraged for at-risk patients at first diagnosis
  • Patients who smoke should quit, and secondhand smoke should be avoided
  • Alcohol intake should be limited to 1 drink/day for women and 1 - 2 drinks/day for men
  • The treatment goals for SIHD are to improve function, prevent future cardiovascular events, and reduce the risk of cardiovascular death
  • Antiplatelet and antianginal drug regimens are used together to achieve treatment goals
  • Aspirin is the recommended antiplatelet, and clopidogrel is used when there is a contraindication to aspirin
  • Low-dose rivaroxaban in combination with aspirin is FDA-approved to reduce the risk of cardiovascular events
  • Beta-blockers are first line for antianginal treatment, followed by calcium channel blockers and long-acting nitrates
  • High-intensity statin treatment is recommended for patients with SIHD
  • Hypertension, heart failure, and diabetes should be aggressively managed with guideline-recommended treatments
  • Annual influenza vaccine is recommended for patients with SIHD
  • Aspirin and clopidogrel have specific dosing, warnings, and side effects, and their use should be monitored for potential drug interactions

Treatment Approach for Stable Ischemic Heart Disease

  • Medically supervised programs, such as cardiac rehabilitation, are encouraged for at-risk patients at first diagnosis
  • Patients who smoke should quit, and secondhand smoke should be avoided
  • Alcohol intake should be limited to 1 drink/day for women and 1 - 2 drinks/day for men
  • The treatment goals for SIHD are to improve function, prevent future cardiovascular events, and reduce the risk of cardiovascular death
  • Antiplatelet and antianginal drug regimens are used together to achieve treatment goals
  • Aspirin is the recommended antiplatelet, and clopidogrel is used when there is a contraindication to aspirin
  • Low-dose rivaroxaban in combination with aspirin is FDA-approved to reduce the risk of cardiovascular events
  • Beta-blockers are first line for antianginal treatment, followed by calcium channel blockers and long-acting nitrates
  • High-intensity statin treatment is recommended for patients with SIHD
  • Hypertension, heart failure, and diabetes should be aggressively managed with guideline-recommended treatments
  • Annual influenza vaccine is recommended for patients with SIHD
  • Aspirin and clopidogrel have specific dosing, warnings, and side effects, and their use should be monitored for potential drug interactions

Treatment Approach for Stable Ischemic Heart Disease

  • Medically supervised programs, such as cardiac rehabilitation, are encouraged for at-risk patients at first diagnosis
  • Patients who smoke should quit, and secondhand smoke should be avoided
  • Alcohol intake should be limited to 1 drink/day for women and 1 - 2 drinks/day for men
  • The treatment goals for SIHD are to improve function, prevent future cardiovascular events, and reduce the risk of cardiovascular death
  • Antiplatelet and antianginal drug regimens are used together to achieve treatment goals
  • Aspirin is the recommended antiplatelet, and clopidogrel is used when there is a contraindication to aspirin
  • Low-dose rivaroxaban in combination with aspirin is FDA-approved to reduce the risk of cardiovascular events
  • Beta-blockers are first line for antianginal treatment, followed by calcium channel blockers and long-acting nitrates
  • High-intensity statin treatment is recommended for patients with SIHD
  • Hypertension, heart failure, and diabetes should be aggressively managed with guideline-recommended treatments
  • Annual influenza vaccine is recommended for patients with SIHD
  • Aspirin and clopidogrel have specific dosing, warnings, and side effects, and their use should be monitored for potential drug interactions

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Test your knowledge of the treatment approach for stable ischemic heart disease with this quiz. Explore the recommended medications, lifestyle modifications, and management strategies to prevent future cardiovascular events and improve patient outcomes.

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