SIHD, ACS, AntiCoagulation -
Pharm Exam 2 questions and
answers
What does ischemic heart disease result from?
Imbalance between myocardial oxygen supply & oxygen demand
What is the most common clinical manifestation of stable ischemic
heart disease?
Chronic stable angina
Optimizing pharmacotherapy for ISH includes what?
1. reduce symptoms
2. improve quality of life
3. slow disease progression
4. prevent ACS
What are the 5 big risk factors for cardiovascular disease?
1. HTN
2. abdominal obesity
3. dyslipidemia
4. insulin resistance (DIABETES)
5. SMOKING
What is a hallmark feature of SIHD in one or more of the major
coronary arteries that impedes coronary blood flow such that
myocardial oxygen supply can no longer meet oxygen demand?
Atherosclerotic plaque
What is a hallmark feature of ACS?
Thrombus formation
What is thrombus formation? What happens?
, Atherosclerotic plaque ruptures (fissuring of fibrous cap and
exposure) causing thrombus formation
What is vasospasm? Is there atherosclerosis? When does it happen
and what are consequences?
Smooth muscle spasm in coronary a. causing ischemia
-NO atherosclerosis
-Happens @ rest, in early AM
-may lead to ischemia and MI
What can cause a vasospasm? What else is it called?
-cocaine
-amphetamines
-cold temperature
-smoking
Prinzmetal or Variant Angina
What is demand ischemia?
Because coronary a. fill during diastole, decreases in diastolic filling
time (fast hr) can lead to diminished myocardial oxygen
delivery and precipitate angina in the face of adequate coronary
perfusion
What can cause demand ischemia?
-sepsis or septic shock
-afib or other tachyarrhythmias
-acute blood loss anemia
During a cardiac catherization, IV contrast dye (____________) is
squirted into coronary arteries via the _________ artery under
fluoroscopic imaging to show ___________.
During a cardiac catherization, IV contrast dye (iohexol/Omnipaque)
is squirted into coronary arteries via the femoral/radial artery under
fluoroscopic imaging to show blockages.
Risks or CIs of a cardiac cath?
Contrast dye = nephrotoxic
-contrast-induced nephropathy = major risk
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