1. Chest pain background science Flashcards
Name the 3 layers of the heart wall
endocardium
myocardium
epicardium
which layer of the heart houses the vessels and nerves of the conducting system of the heart (purkinje fibres)
subendocardial layer
the coronary arteries run within which layer of the heart
epicardial layer
Coronary flow occurs predominantly during which period; systole or diastole
Diastole
when the myocardium is relaxed, and the smaller coronary vessels are not squeezed by the contracting myocardium
What is the result of tachycardia on the heart
increases myocardial oxygen demand
decreases coronary blood flow
Where do the coronary arteries arise from
aortic sinus (small bulges in the aorta above the aortic valve)
What are the main branches of the LCA
LAD , left marginal and left circumflex
what are the main branches of the RCA
right marginal and posterior descending
Venous drainage of the myocardium (the heart) is via what
the coronary sinus
the coronary sinus delivers deoxygenated blood to which part of the heart
the right atrium
Name the symptoms of atherosclerosis in the coronary arteries
vomiting, anxiety, angina, coughing, feeling faint
what are the symptoms of atherosclerosis in the carotid arteries (remember it supplies the brain)
weakness, dysphagia, headache and facial numbing
what are the symptoms of peripheral vascular disease
hair loss, erectile dysfunction and weakening
What are the symptoms of atherosclerosis in the renal artery
reduced appetite, hand or feet swelling
increased renin release which leads to increase BP
Define coronary artery disease/ IHD
poor or no blood flow to the heart tissue and is linked to angina
this can lead to MI
what is heart failure
when the heart is unuable to maintain a strong blood flow and results in chronic tiredness, reduced physical activity and SOB
Troponin test (I and T) are recommended as options for the early rule out of what
NSTEMI in patients with chest pain and suspected ACS
Out of the following conditions, which will cause an increase in troponin and creatine kinase and which will not;
unstable angina
NSTEMI
STEMI
unstable angina will not have increased troponin
NSTEMI and STEMI will have increased troponin
describe the change in troponin levels post MI
start to rise afte 3 hours
continue to rise for 12 hours
peak at 24 hours
tail off after 72 hours
