Overview of Coronary Artery Disease

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Coronary Artery Disease (CAD) / Ischemic Heart Disease (IHD) Revision Sheet

1. 📌 Essentials

  • CAD/IHD results from an imbalance of myocardial oxygen supply and demand.
  • Stable angina is exertional chest pain relieved by rest/nitroglycerin.
  • Unstable angina and MI are forms of acute coronary syndrome with prolonged, unrelieved pain.
  • Atherosclerosis (95%) is the main cause of coronary stenosis.
  • Vasospasm (5%) causes functional restenosis; embolism can occlude arteries.
  • Typical angina: retrosternal, radiates to arm, jaw, shoulder; constrictive or heavy sensation.
  • ECG changes: T wave inversion (ischemia), ST elevation (injury), Q waves (necrosis).
  • Cardiac enzymes (Troponin, CPK) rise during MI but not in stable angina.
  • Coronary angiography confirms stenosis location and severity.
  • Revascularization: PTCA, stents, CABG; pharmacotherapy includes nitrates, antiplatelets, anticoagulants.
  • Rest: myocardial oxygen demand and supply are balanced at 3 Oxygen/sec; exercise raises demand to 9 Oxygen/sec, demand-supply mismatch causes ischemia.
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Преглед на теста

1. What is the typical oxygen demand and supply for the myocardium at rest and during exercise?

2. What percentage of coronary artery stenosis is caused by atherosclerosis according to the revision sheet?

3. In the context of normal oxygen supply and demand, what does a significant mismatch indicate?

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Преглед на флашкартите

What is the normal oxygen demand and supply for the myocardium at rest and during exercise?

At rest, the myocardium's oxygen demand and supply are balanced at 3 oxygen units per second. During exercise, both increase to 9 oxygen units per second due to increased coronary blood flow.

CAD — main cause?

Atherosclerosis (95%)

How does an imbalance between oxygen demand and supply manifest in ischemic heart disease?

When oxygen demand exceeds supply, especially during exertion, it leads to myocardial ischemia, which manifests clinically as angina or other ischemic symptoms.

Stable angina — relief?

Relieved by rest or nitroglycerin

What is myocardial ischemia and how does it relate to imbalance in oxygen supply and demand?

Myocardial ischemia occurs when there is an imbalance between myocardial oxygen demand and supply, typically due to reduced blood flow from coronary artery problems, leading to insufficient oxygen being delivered to the heart muscle during increased demand such as exertion.

ECG signs — ischemia, injury, necrosis?

T wave inversion, ST elevation, Q waves

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Колко въпроса има в теста за Overview of Coronary Artery Disease?

Тестът съдържа 36 въпроса с множество отговори с подробни корекции и обяснения за всеки отговор. Идеален за тестване на знанията ви и идентифициране на пропуски.

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