Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology > 18 Alterations in Cardiac Function > Flashcards

18 Alterations in Cardiac Function Flashcards

1
Q

Coronary Heart Disease [CHD]

common names

A

Ischemic Heart Disease

Coronary Artery Disease [CAD]

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

Coronary Heart Disease [CHD]

A

-characterized by insufficient delivery of oxygenated blood to the myocardium due to atherosclerotic coronary arteries

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

sequelae

A

a condition which is the consequence of a previous disease or injury

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

Coronary Heart Disease [CHD]

sequelae

A

1 Angina Pectoris (3 types, myocardial infarction)
2 Dysrhythmias
3 Heart failure
4 Sudden cardiac death

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

Coronary Heart Disease [CHD]

risk factors

A

atherosclerosis-main cause

microcirculation abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does atherosclerosis lead to cardiac ischemia/CHD

A

narrowing of arterial lumen can lead to thrombus formation, coronary vasospasm, endothelial cell dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

vulnerable plaques vs stable plaques

A

V: large lipid core, thin cap, high shear stress

S: more collagen + fibrin, stable cap

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

vulnerable plaques may rupture and erode which stimulates…

A

clot formation on the plaque

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

Ischemia

A

oxygen supply is insufficient to meet metabolic demands

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

critical factors in meeting cellular demands for oxygen

A

1 rate of coronary perfusion

2 myocardial workload

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

coronary perfusion can be altered by

A

1 large, stable atherosclerotic plaque
2 acute platelet aggregation + thrombosis
3 vasospasm
4 failure of autoregulation by microcirculation
5 poor perfusion pressure

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

chronic occlusion of a coronary vessel leads to…

A

STABLE ANGINA

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

acute occlusion leads to

A

plaque disruption + thrombus formation

-results in UNSTABLE ANGINA or MI

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

Angina Pectoris

A

chest pain associated w intermittent myocardial ischemia

-no permanent myocardial damage occurs

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

Angina Pectoris

symptoms

A

burning, crushing, squeezing, choking or referred pain

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

Angina Pectoris may result in…

A

inefficient cardiac pumping w resultant pulmonary congestion + shortness of breath

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

myocardial ischemia may UNCOMMONLY be caused by…

A

1 coronary vasospasm
[PRINZMETAL or VARIANT ANGINA]
2 hypoxemia
3 low perfusion pressure fr vol depletion or shock

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

3 types of angina

A

Stable Angina (stable or typical or classic)
Unstable Angina
Prinzmetal or Variant Angina

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

Stable or Typical or Classic Angina

A
  • most common

- characterized by stenotic atherosclerotic coronary vessels

20
Q

Stable or Typical or Classic Angina

onset + treatment

A
  • onset of anginal pain is generally predictable + elicited by similar stimuli each time
  • relived by rest + nitroglycerin
21
Q

Unstable or Crescendo Angina

A
  • 1 of 3 types of Acute Coronary Syndrome
  • similar to Stable Angino but NO RELIEF W/O MEDICAL HELP
  • may progress to acute ischemia
22
Q

Prinzmetal or Variant Angina

A

-unpredictable attacks of anginal pain

characterized by:

  • vasospasm,
  • atherosclerosis-induced hypercontractility,
  • abnormal secretion of vasospastic chem by local mast cells,
  • abnormal Ca flux across vascular smooth muscle
23
Q

Prinzmetal or Variant Angina

onset

A
  • onset of symptoms is UNRELATED to phys or emo exertion, heart rate, or other obvious causes of increased myocardial oxygen demand
  • UNPREDICTABLE
24
Q

Acute Coronary Syndrome

A

3 types; 1 is unstable angina

-caused by plaque rupture w acute thrombus dvlpt

25
Q

Acute Coronary Syndrome

signs + symptoms

A

chest pain usually more severe, last longer than 15 mins, may radiate to limbs, jaw, back

  • nausea, vomiting, diaphoresis, shortness of breath
  • not relieved by rest or nitroglycerin
  • in unstable angina: occlusion is partial
  • in MI: occlusion is complete
26
Q

Asymptomatic/Silent MI

A
  • women, elderly, + patients w neuropathies

- atypical symptoms like fatigue, nausea, back pain, + abdominal discomfort

27
Q

Acute Coronary Syndrome

diagnosis

A

must have 2 out of 3
1 S/S
2 electrocardiographic changes [ECG]
3 Biomarkers (elevation of spec. marker proteins in blood)

28
Q

acute occlusion causes a range of cellular events depending on…

A
  • availability + adequacy of collateral blood flow
  • relative workload
  • length of time that flow is interrupted
29
Q

ultimate size of infarcted tissue depends on…

A

extent
duration
severity of ischemia

30
Q

Acute Coronary Syndrome

histology

A

18-24 hrs: DEC BF: area of infarction becomes paler than surround ing tissues
5-7 days: NECROSIS/GANGRENE: turns yellow w soft rim of red vascular connectv tissue
1-2 wks: CLEARNCE: necrotic tissue degraded + cleared away; infarcted myocardium weakened + susceptible to rupture
<6wks: REPAIRMNT: necrotic tissue replaced by tough fibrous scar tissue

31
Q

Acute Coronary Syndrome

Serum Marker Changes for diagnosis

A
  • intracellular becomes extracellular
  • myoglobin, troponin, lactate dehydrogenase, + creatine kinase
  • increased CK-MB + TROPONIN I + T
32
Q

Acute Coronary Syndrome

ECG changes for diagnosis

A

1 ST-segment elevation
2 large Q waves
3 inverted T waved

33
Q

ST-segment elevation for Acute Coronary Syndrome

A

STEMI: patients w chest pain + evidence of acute ischemia on ECG
NON-STEMI/NSTEMI: patients presenting symptoms of unstable angina + NO ST elevation on ECG

34
Q

treatments for 2 types of ST-segment elevations

A

STEMI: candidates for ACUTE REPERFUSION THERAPY

NSTEMI: candidates for ANTIPLATELET DRUGS

35
Q

MI leads to drop in CO which triggers…

A

compensatory response

36
Q

Sympathetic nervous sytm activation leads to__ by__

A

leads to increased myocardial workload by increasing
heart rate,
contractility,
BP

37
Q

Acute Coronary Syndrome

treatment principals

A

1 decreasing myocardial oxygen demand
2 increasing myocardial oxygen supply
3 monitor + manage complications [SNS activation]

38
Q

decreasing myocardial oxygen demand for treating ACS

A
  • sympathetic antagonist,
  • rest,
  • heart rate control,
  • pain relief,
  • afterload reduction
39
Q

increasing myocardial oxygen supply for treating ACS

A
  • thrombolysis,
  • angioplasty,
  • coronary bypass grafting
40
Q

monitor + manage complications [SNS activation] for treating ACS

A
  • early detection + mgmt of dysrhythmias + conduction disorders
  • continuous ECG monitoring
41
Q

clinical treatments for ACS

A

Morphine: pain (+dec O2 demand)
Oxygen: ischemia
Nitroglycerin: ischemia
Anticoagulants: ischemia (platelet thinner or thrombolysis)

42
Q

Stenosis**

A

failure of the valve to open completely

-results in extra pressure work for the heart

43
Q

Regurgitation (Insufficiency)*****

A

inability of a valve to close completely

-results in extra volume work for the heart

44
Q

Valvular Disease

A

congestion upstream + low blood supply downstream

2 types: stenosis + regurgitation

45
Q

Valvular Disease

clinical manifestations

A
  • murmrs are common

- heart failure S/S

46
Q

myocardial infarction biomarkers of choice**

A

troponin I + T

Pathophysiology (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions