3.3.2. Cardiac Pathology Part 1: Ischemic, CHF, Congenital Defects Flashcards
Ischemic heart disease is usually due to what?
Atherosclerosis of coronary arteries
What is stable angina?
Get angina with stress or activity
Why in stable angina do we not always have pain?
It’s mild decreased blood flow in the coronary artery, but when we exercise and need more blood to the heart tissue, we can’t get it, it gets a little ischemic, and we feel pain
In Stable Angina, it is due to atherosclerosis of coronary arteries with ____ ____.
> 70% stenosis
What type of injury is stable angina?
It is reversible!
in Stable Angina, the cells don’t die, hence it being reversible. However, they do do this…
Get bigger
Presentation of Stable Angina
- CP < 20 minutes that radiates to left arm or jaw
- Diaphoresis
- SOB
What EKG finding do we get with Stable Angina? Why?
ST Depression due to subendocardial ischemia
Why is the damage caused by Stable Angina subendocardial?
Coronary arteries feed epicardium to endocardium, so if there is a blockage, the most affected portion will be the latest, which typically happens just below the endocardium, or, subendocardial.
Treatment for Stable Angina?
Rest or NTG
What is unstable angina?
Pain even at rest due to a rupture of an artherosclerotic plaque with thrombosis and incomplete occlusion of the coronary artery.
How is reversibility different between stable and unstable angina?
It’s not both irreversible
What is an important note about the occlusion in unstable angina?
It is incomplete occlusion
EKG and treatment for unstable angina
NTG, EKG shows ST depression
For unstable angina we have a high risk for ____.
MI
Prinzmetal angina is what?
Vasospasm of the coronary artery
What is different about prinzmetal angina from stable and unstable angina?
Prinzmetal is complete and random occlusion, so the chest pain is still episodic, but it is completely unrelated to exertion
EKG for prinzmetal angina? Why?
ST elevation because the early part of the coronary artery is clamped in the epicardium, so the blood is lost through the entire vessel whih leads to ST elevation.
Treatment for Prinzmetal Angina
NTG and Ca Channel blockers
What is a myocardial Infarction?
Necrosis of cardiomyocytes due to a rupture of the atherosclerotic plaque leading to a thrombosis and complete occlusion of the coronary artery
How long does it take for the cardiac tissue to turn necrotic?
> 20 minutes
How can vasculitis cause an MI?
Inflammed interior wall, coag pathway, thrombus, complete occlusion results.
Presentation for MI
- Severe crushing chest pain > 20 minutes
- Diaphoresis
- Dyspnea
Effect of NG on an MI
None.