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Angina SIHD part 1 questions and answers 2024.
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Angina SIHD part 1 questions and answers 2024.
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Angina/SIHD part 1 questionsand answers 2024
Ranolazine (Ranexa)
inhibits the late phase of the inward sodium channel during cardiac
repolarization reducing intracellular sodium concentrations and
thereby reducing calcium influx via Na+-Ca2+ exchange that in turn
reduces ventricular tension and myocardial oxygen consumption.
It has NO CLINICALLY SIGNIFICANT HR OR BP LOWERING EFFECT
ONLY IMPROVES PERFUSION OF HEART.
Acute coronary syndrome
A group of symptoms caused by myocardial ischemia; includes
angina and myocardial infarction.
Stable vs unstable acute coronary syndrome
acute coronary syndrome symptoms
-Substernal chest discomfort, radiating to left arm (not relieved by
nitrates in an MI)
-Dyspnea
-Diaphoresis
-Nausea
Number one killer for men and women
Acute coronary syndrome
ACS includes
unstable angina, NSTEMI, STEMI
NSTEMI
Non ST segment elevation MI; a heart attack that is not diagnosed
on the EKG but is diagnosed by an elevated troponin on blood test
STEMI
,ST elevation MI, real-time ongoing death of heart tissue due to
ischemia
unstable angina
chest pain that occurs while a person is at rest and not exerting
himself
2023 update has what new term
chronic coronary disease
What is CAD
Formation of atherosclerotic plaques in coronary arteries.
Impedes blood flow and reduces oxygen demand
What is Ischemia
Decreased blood flow and O2 supply to myocardium causing
increased demand and issues
Angina Pectoris
chest pain that results when the heart does not get enough oxygen
This sensation is more Discomfort/pressure/burning in the chest,
and adjacent areas
DUE TO ISCHEMIA
myocardial infarction (MI)
Necrosis of myocardial tissue due to prolonged ischemia
CCD
heterogenous group of conditions
includes obstructive and non obstructive CAD
WITH OR WITHOUT
-Previous MMI or revascularization
-Ischemic heart disease diagnosed only by noninvasive testing
-chronic angina syndromes and underlying causes
Angina and Chest pain is mostly a symptom of
Obstructive CAD
we want to manage
, the underlying causes and protective therapies for both
Obstructive and non obstructive CAD
Consequences of myocardial ischemia
Stable angina, vasospastic angina
ACS
-Unstable Angina
-Acute Myocardial Infarction
-arrhythmias
-Congestive heart failure (CHF)
-sudden cardiac death.
How many adults aged 20 and above are affected by CAD?
20.1 million
What is often the first sign of CAD?
Angina
What percentage of all CVD related mortality is attributed to CAD?
42%
What was the estimated cost of CAD?
220 billion
How does CAD impact quality of life?
Reduces it
Mortality of CAD increases with
1. number of coronary vessels with lesions increase
2. Patients with left main coronary artery (major blood supply to the
heart)
3. Reduced Ejection fraction (EF) <40-50%
Coronary arteries
blood vessels that branch from the aorta and carry oxygen-rich
blood to the heart muscle
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