Heart Failure & Valvular Diseases Q 25 - Gyan Darpan : Learning Portal
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Thursday 28 April 2022

Heart Failure & Valvular Diseases Q 25

Which of the following types of angina is most closely related with an impending MI?
     A. Angina decubitus
     B. Chronic stable angina
     C. Nocturnal angina
     D. Unstable angina

Correct Answer: D. Unstable angina

Unstable angina progressively increases in frequency, intensity, and duration and is related to an increased risk of MI within 3 to 18 months. Evidence shows that patients with new-onset ST-segment elevation (more than 1 mm) have a 12-month rate of an MI or death of about 11%, compared to only 7% for patients who only have isolated inversion of the T wave. Unstable angina results when the blood flow is impeded to the myocardium. Most commonly, this block can be from intraluminal plaque formation, intraluminal thrombosis, vasospasm, and elevated blood pressure.

Option A: Angina decubitus is a variant of angina pectoris that occurs at night while the patient is recumbent. Some have suggested that it is induced by an increase in myocardial oxygen demand caused by expansion of the blood volume with increased venous return during recumbency.
Option B: The most important complication of stable angina is the possibility of progression to acute coronary syndrome. Risk factor modification and medical optimization should be utilized to decrease risk. These individuals require routine monitoring and attentive primary care providers.
Option C: Several authors have noted increases and irregularity of heart rate, respiration, and arterial pressure occurring in nearly all instances of D-sleep (sleep associated with dreaming). Shifts in the blood pressure might be dangerous to a cardiac patient, and as early as 1921, it had been suggested that sudden death during sleep of patients with heart disease was probably caused by blood pressure changes associated with dreaming.

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