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02. Coronary Artery Disease
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orange-fifteen-kansas-sierra-triple-mango
Status
Last Update
Fields
Published
06/26/2023
CAD Acute coronary syndromes MI → {{c1::STEMI}} and {{c1::NSTEMI}}Disturbances of conduction {{c2::AV Blocks}} and BBBArrythmiasVT…
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06/26/2023
defintions Coronary artery disease → usually refers to the pathologic process causing narrowing of the {{c1::coronary arteries}}, usually fr…
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06/26/2023
epidemiology 55% of male lifetime risk of those over 40 years of age 49% lifetime risk of developing CHD in {{c1::men}}32% chance …
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06/26/2023
Risk factors for CAD more than 90% of CHD events occur in those having at least one risk factor around 8% occur in those w/ only borderline …
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06/26/2023
ACC/AHA risk calculator predicts 10 year CV risk, decide whether to use {{c1::statin}} or {{c1::aspirin}}
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pathophysiology summary initiated by {{c1::endothelial damage}}migration of {{c1::inflammatory cells}} → {{c1::monocytes}} into in…
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pathophysiology
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outcome of pathophysiology gradual narrowing over time → often slow development of symptoms acute plaque rupture → often {{c1::ACS}}
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06/26/2023
diagnosis → what is your pretest probability history HPI, past hx, family hx, social hx, ROS take history, active not passive acquisiti…
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06/26/2023
diagnosis of angina pectoris clinical features pressure, heaviness, tightness or constriction to {{c1::left}} or center of chest w…
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06/26/2023
history to take for chest pain {{c1::quality}}{{c1::duration}}{{c2::location}}{{c2::provocation}}
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Clinical manifestations chest pain {{c1::may/may not}} be presentdyspneaorthopnea {{c1::PND}}dizzinessdiaphoresis palpitations syn…
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06/26/2023
physical exam check vital signs for most pts w/ stable angina → PE findings {{c1::may be normal}}other signs of atherosclerosis → …
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06/26/2023
diagnosis CBC → check {{c1::hemoglobin}}BMP → check {{c1::glucose, electrolytes, Cr}}Cardiac enzymes if {{c2::active chest pain}}r…
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06/26/2023
diagnosis → 12 lead resting ECG should be recorded in all pts w/ symptoms suggestive of {{c1::angina pectoris}}normal in 50% of pts w/ …
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06/26/2023
diagnosis → stress test exercise of pharmacologic stress w/ {{c1::ECG}}exercise of pharmacologic stress w/ {{c1::Echocardiogram}}exercise of phar…
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06/26/2023
diagnosis → angiography depending on stress test results can either consider medical therapy or consider sending pt for a {{c1::coronary ang…
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06/26/2023
coronary angiography
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06/26/2023
risk assessment high risk features Low EF → {{c1::<35%}}High risk ECG findings on ecg stress test high risk stress imaging feat…
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06/26/2023
chronic stable angina treatment objectives reduce the risk of {{c1::mortality}} and {{c1::morbid}} events reduce {{c1::s…
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06/26/2023
treatment → ABCDEA = {{c1::Aspirin/antianginal therapy}}B = {{c1::Beta blocker and BP}}C = {{c2::cigarette smoking cessation}} and …
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06/26/2023
antiplatelet agents aspirin {{c1::81mg}} daily should be routinely used in all pts w/ acute/chronic ischemic heart disease w/ or w/o manifes…
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06/26/2023
statins
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06/26/2023
antianginal and anti-ischemic tx beta-andrenoreceptor blocking agents CCB nitrates short acting → sub-lingual {{c1::nitroglyc…
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06/26/2023
successful treatment elimination of angina chest pain return to {{c1::normal activities}}functional capacity good pt compliance → minim…
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06/26/2023
long ass flow chart
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06/26/2023
revascularization revascularization PCI CABG indications high grade {{c1::coronary lesions}} → main artery {{c1::Le…
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06/26/2023
PCI vs CABG
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