Treatment

• Fill in the blanks

  A) lifestyle

  B) nitrates

  C) beta

  D) Ca+2 channel

  E) nitrate

  F) and

  G) revascularization

  H) PCI

  I) CABG

  J) Ivabradine

  K) Nicorandil

  
• Why are vasodilators used in angina?

  Increase blood flow
• Why are beta blockers used in angina?

  Reduce HR & BP

  Reduce myocardial O2 consumption

  Increase time in diastole (more coronary artery filling)
• What are Ca+2 channel blockers used in angina?

  Inhibit Ca+2 channel in myocardium, cardiac conductive tissue & vascular smooth muscle
• What is PCI?

  Percutaneous Coronary Intervention

  Process of dilating coronary artery stenosis -> introduce inflatable balloon & metallic stent
• What are the complications of PCI?

  Bleeding

  Haematoma

  Dissection

  Pseudo-aneurysm from arterial puncture site

  Acute MI

  Stroke

  Death
• What is CABG?

  Coronary Artery Bypass Grafting

  Autologous veins ar arteries are anastomosed to the ascending aorta & to native coronary arteries distal to area of stenosis

  
• What is the initial management of MI?

  Give aspirin = prevent clots

  Cardiac ischaemia pain = IV morphine

  O2

  Primary PCI = insert stent to restore blood flow

  Dual anti-platelet therapy = aspirin with clopidogrel
• What is the procedure of an angioplasty?

  Use local anaesthetic

  Thin, flexible tube inserted into an artery in groin, wrist or arm & guided to affected coronary artery by X-ray video

  When catheter is in place, a thin wire is guided down the length of the coronary artery to deliver a small balloon to affected section

  Balloon inflated to widen artery -> squashes fatty deposits against wall

  Stent expands & stays in place after balloon is deflated and removed
• What are the contraindications of statins?

  Pregnancy

  Breast feeding

  Active hepatic disease
• Why do you not use vasodilators, like dipyridamole, in angina?

  Coronary steal -> even less blood flow through ischaemic area as collateral vessels are not dilated

  
• What is an angioplasty?

  Procedure used to widen blocked/narrowed coronary arteries
• What is one of the major side effects of statins?

  Rhabdomyolysis -> can lead to myoglobin release (tea coloured urine)
• Why is chewable aspirin given in MI?

  Faster absorption