PANCE REVIEW: Ischemic Heart Dz

Angina

1-Stable = < 3min during activity, better with rest

2-Unstable = > 30 min at rest

3-Prinzmetal = vasospasm at rest

Risk Factors (10):

-male
-increased age
-decreased estrogen state
-smoking
-fam hx
-HTN
-DM
-obesity
-dyslipidemia
-inactivity

Tests/Labs:

-EKG: horizontal or downslopping  ST seg (depression)
-Exercise Test: good non-invasive test
*Pimping Question: What signifies a positive exercise test? (Answer below)
-ECHO: prognostic indicator

Tx:

-sublingual nitro is the primary pharm tx
-chronic angina = beta blockers (prolong life)
-CCB decrease cardiac muscle O2 demand
-Platelet inhibition agent (aspirin, clopidogrel, ticlopidine)
-NOTE: Nitro and CCB only for Prinzmetal! Beta-blockers can provoke a spasm!





Answer: ST segment depression of 1mm


Source: AAPA and PAEA Exam Review Book