Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

2 Path Unit > 10/23 Ischemic Heart Disease > Flashcards

10/23 Ischemic Heart Disease Flashcards

1
Q

What is the number one cause of death in the U.S.?

A

Heart Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dominant cause of ischemic heart disease is?

A

insufficient coronary perfusion (due to narrowing of epicardial coronary arteries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T/F Most ischemic heart disease has an asymptomatic phase?

A

T

[sudden cardiac death is first symptom in 50%!]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do coronaries fill? Tachycardia does what to this

A
  • diastole

- Reduces filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Review coronary anatomy!

A
  • LMA->LCX (plus OM1 & 2)
  • LMA->LAD (Plus D1, D2)
  • RCA->PL and PD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

total occlusion of what branch takes out 15% of Left Ventricle? 35%? 50%?

A
  • LCX (left circumflex)
  • RCA
  • LAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Plaques are found at which location in LCA? Which location in RCA?

A
  • proximal LAD and LCX

- Entire length of RCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Soft plaques are made of?

A

necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hard plaques are made of?

A

fibrocalcific substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Coronary occlusion grading follows what scale? When is it considered symptomatic?

A

-Less than 25% occluded= Grade 1
-26-50%=Grade 2
…and so on
-Grade 4 is considered “severe” and has symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Severe left main artery disease has what prognosis?

A

high rate of sudden death. [usually occurs w/ severe 3-vessel disease]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Little white chunks in a coronary artery seen on X-ray is called what?

A

plaque calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F collateral arteries dilate and grow when stimulated by downstream ischemia?

A

T. [non-functional normally though]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F chronic coronary lesions typically can vasospasm or hemorrhage?

A

F, chronic are typically stable, slowly enlarging.

-Acute are rapidly enlarging, prone to rupture at any grade, thrombose, hemorrhage, and vasospasm (endothelial injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Am I typical of chronic or acute coronary lesions: unstable angina?

A

acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Am I typical of chronic or acute coronary lesions: asymptomatic ischemic heart disease

A

Both!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Am I typical of chronic or acute coronary lesions: stable angina

A

chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Am I typical of chronic or acute coronary lesions: myocardial infarction

A

acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Am I typical of chronic or acute coronary lesions: Heart failure

A
  • chronic heart failure in chronic coronary lesions, while…
  • acute heart failure in acute coronary lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Am I typical of chronic or acute coronary lesions: sudden death

A

acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what 3 fates can occur after a CORONARY plaque rupture?

A
  • healing
  • embolism
  • thrombosis (most common & clinically significant! More than embolism.)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what 3 fates can occur after a CORONARY plaque rupture which leads to THROMBOSIS?

A
  • organization (Most common!!)
  • embolization
  • obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Plaque progression is which? a)more fat deposited OR b)repeated episodes of plaque rupture, thrombosis, organization

A

B.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

T/F plaque instability can occur an any stage of narrowing?

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hemorrhage within a plaque may lead to?
-acute coronary syndrome (possibly by inducing vasospasm)
26
concentric plaques are nice, because they prevent?
vasospasm
27
Ischemia is defined as?
- myocytes remain viable - sublethal [may produce angina, arrhythmia, or heart failure!]
28
acute ischemia looks like what on histo?
normal myocytes OR with contraction bands
29
chronic ischemia looks like what on histo?
vacuolated myoctyes w/ decreased contractile elements
30
Infarction is defined as?
-non-salvageable myocytes
31
Acute infarction looks like what on histo?
coagulative necrosis w/ contraction bands, apoptosis, wavy fibers. Depending on time afterward: neutrophils, macrophages, granulation tissue, scarring
32
_________ myocardium is most susceptible to ischemia
subendocardial
33
As ischemia/infarction progress, they expand in what directions?
radially outward, and transmurally toward the epicardium
34
How many hours of severely reduced perfusion result in permanent damage?
this is weird but... | -"at least 2 to 4 hours" ("necrosis is usually complete within 6")
35
What is the wavefront phenomenon?
progression of MI from subendocardial to transmural
36
What type of MI result in relatively discreet infarcts and occur in very specific locations?
acute MI associated with coronary artery occlusion
37
What type of MI is circumferentially distributed around the LV?
acute MI associated with global hypoperfusion
38
What type of infarcts are found in embolic disease?
focal acute MI that may not be subendocardial and are not in specific coronary distribution
39
What type of MI is STEMI?
transmural
40
What type of MI is non STEMI?
subendocardial
41
Is transmural or subendocardial more common?
transmural [involves half of myocardial thickness]
42
How does a subendocardial MI occur?
rapid lyses of coronary thrombus or prolonged hypo perfusion of heart
43
When do macrophages start cleaning up an MI inflammation? granulation tissue?
8-11 days | 11-14 days
44
When does collagen deposition take place?
day 14+
45
When does death of neutrophils take place?
5-7 days
46
What does a week one MI infarct look like?
begins dark mottling yellow-tan from increasing neutrophils/necrosis border of infarct stays hyperemic
47
What is karyorrhectic debris symbolic of in MI recovery?
neutrophils starting to die
48
What does a week two MI infarct look like?
center is maximally yellow tan and soft with a depressed red/gray border of granulation
49
Which direction of clean up takes place?
outside in,
50
What cells are a main component of granulation tissue that you should be able to point out
fibroblasts (residual chronic inflammatory cells too)
51
What does a week 3-4 MI look like microscopically?
fibrosis with numerous fibroblasts, pink collagen, and very sparse chronic inflammatory cells
52
What color is collagen in trichrome?
blue
53
Review the following list of complications of MI
arrhythmias, contractile dysfunction, rupture, RV infarct, expansion, extension, aneurysms in the ventricle, thrombus, progressive late heart failure, pericarditis
54
What are the 4 main outcomes of electrical failure following MI?
acute arrhythmias non-lethal arrest- resuscitated sudden death
55
What are the 3 outcomes of pump failure following MI?
acute HF cardiogenic shock [>40% LV loss] chronic HF
56
When is myocardial rupture most common?
3-7 days post MI, correlates with maximal degradation`
57
Is a free wall rupture fatal?
rapidly
58
Papillary muscle rupture commonly leads to what?
acute mitral regurg
59
Is the free wall rupture most common?
Yes- anterolateral wall
60
What are the risk factors of myocardial rupture?
``` > 60 years old Female>male chronic hypertension No LV hypertrophy FIRST MI !!!!!!!!!![no scars that block] ```
61
Is there high mortality in rupture of ventricular septum?
Yes- this is why we repair it. Acute L>R shunt
62
What location does papillary muscle rupture occur most?
post-medial
63
Is infarct extension or infarct expansion more commonly associated with mural thrombus and poorer prognosis?
Infarct expansion
64
What are the 3 main consequences of aneurysm in the myocardial wall?
-arrhythmias -mural thrombus -chronic heart failure [no rupture after 1 mo]
65
What is chronic ischemic heart disease also known as? What is commonly seen 6 (for review)?
1. ischemic cardiomyopathy 2. progressive heart failure, previous coronary arterial interventions, LV hypertrophy and dilatation, discreet scars, thickened endocardium, thrombus often.
66
What syndrome is pericarditis following MI? how many days after MI? occur only after transmural MI?
Dressler's, day 2 or 3, yes

2 Path Unit (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions