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IHD - ISCHEMIC HEART DISEASE RXPREP EXAM QUESTIONS AND VERIFIED ANSWERS
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IHD - ISCHEMIC HEART DISEASERXPREP EXAM QUESTIONS AND
VERIFIED ANSWERS
what is ANGINA - ANSWER CHEST PAIN, PRESSURE, TIGHTNESS, or
discomfort, usually caused by ischemia of the heart muscle or spasm of the
coronary arteries
another name for STABLE ANGINA - ANSWER STABLE ISCHEMIC
HEART DISEASE (SIHD)
what is STABLE ANGINA (aka SIHD) - ANSWER PREDICTABLE CHEST
PAIN
- often brought on by EXERTION or emotional stress
- RELIEVED WITHIN MINUTES BY REST or with NITROGLYCERIN
UNSTABLE ANGINA is a type of - ANSWER ACUTE CORONARY
SYNDROME (ACS)
what is UNSTABLE ANGINA - ANSWER a type of ACUTE CORONARY
SYNDROME (ACS)
- a medical emergency where
- chest pain increases (in frequency, intensity, or duration
- is NOT RELIEVED WITH NITROGLYCERIN OR REST
what is PRINZMETAL'S angina - ANSWER when chest pain is caused by
VASOSPASM of the coronary arteries
aka variant or vasospastic angina
what is chest pain is caused by VASOSPASM of the coronary arteries called -
ANSWER PRINZMETAL'S (variant or vasospastic) angina
,what does PRINZMETAL'S angina present as - ANSWER can occur at rest
what causes PRINZMETAL'S (variant or vasospastic) angina - ANSWER can
be caused by illicit drug use, particularly cocaine
what is the pathophysiology of chest pain - ANSWER occurs when there is an
IMBALANCE b/w MYOCARDIAL OXYGEN DEMAND (WORKLOAD)
AND SUPPLY (BLOOD FLOW)
what is CORONARY ARTERY DISEASE (CAD) - ANSWER plaque build
up (ATHEROSCLEROSIS) within the inner walls of the coronary arteries
- it causes narrowing of the arteries and REDUCED BLOOD FLOW TO THE
HEART
(in SIHD (STABLE ANGINA), this usually causes decreased myocardial
oxygen supply
what is the pathophysiology of SIHD (stable angina) - ANSWER - myocardial
oxygen supply is often decreased due to plaque build up
(ATHEROSCLEROSIS) within the inner walls of the coronary arteries (aka
CORONARY ARTERY DISEASE (CAD))
- CAD causes narrowing of the arteries and REDUCED BLOOD FLOW TO
THE HEART
- myocardial oxygen DEMAND INCREASES when the heart is working harder
due to and INCREASED HEART RATE, CONTRACTILITY, or LEFT
VENTRICULAR WALL TENSION [caused by increased preload (systemic
vascular resistance or SVR)]
what are the RISK FACTORS for SIHD - ANSWER similar to other types of
heart disease, vascular disease, and stroke
include:
- htn
- smoking
- dyslipidemia
- diabetes
- obesity
- physical inactivity
, what is done to assess the likelihood of CAD and diagnose SIHD - ANSWER
a CARDIAC STRESS TEST is performed
(increased myocardial oxygen demand with either exercise or IV medications,
then pt is monitored for development of symptoms)
how is a CARDIAC STRESS TEST performed - ANSWER increases
myocardial oxygen demand with either:
- exercise (e.g., walking on a TREADMILL or pedaling stationary bike)
or
- intravenous MEDICATIONS (ADENOSINE, DIPYRIDAMOL,
DOBUTAMINE, or REGADENOSN (LEXISCAN))
as myocardial oxygen demand increases, pt is monitored for development of
symtpoms (e.g., chest pain, dyspnea, lightheadedness), changes in HR and BP,
transient rhythm disturbances or ST segment abnormalities on an ECG
[[when diagnosis of SIHD is certain, coronary angiography can be performed to
assess the extent of atherosclerosis and need for revascularization]]
parts of EVALUATION OF SIHD - ANSWER - HISTORY AND PHYSICAL
- CBC, CK-MB, TROPONINS (I or T), aPTT, PT/INR, LIPID PANEL,
GLUCOSE
- ECG (AT REST AND DURING CHEST PAIN)
- CARDIAC STRESS TEST/STRESS IMAGING
- CARDIAC CATHETERIZATION/ANGIOGRAPHY
what is non-drug tx for IHD - ANSWER - encourage pts to follow a HEART
HEALTHY DIET
- maintain a BMI OF 18.5-24.9 KG/M2
- maintain a WAIST CIRCUMFERENCE OF:
> MALES: <40 IN
> FEMALES: <35 IN
- 30-60 min of MODERATE-INTENSITY AEROBIC ACTIVITY 5-7
days/week (supplemented by increase in daily lifestyle activities (e.g., walking
breaks, gardening))
[medically supervised programs, such as cardiac rehab, are encouraged for at-
risk pts at first diagnosis]
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