8.1 Ischemic Heart Disease Flashcards
What is the usual cause of ischemic heart disease?
Atherosclerosis of the coronary arteries
Stable Angina
Chest pain with exertions as there is some occlusion of the coronary arteries resulting in reversible damage
How long does the pain from stable angina last?
20 minutes or less
What is the EKG change with stable angina?
ST depression - subendocardial ischemia
Unstable Angina
Chest pain that is due to thrombosis with incomplete occlusion and it can occur at rest - reversible injury to myocytes
What is the EKG change with unstable angina?
ST depression
Prinzmetal Angina
Vasospasm of the coronary artery that is unrelated to exertion
What is the EKG change with Prinzmetal angina?
ST elevation due to transmural ischemia
What are the main features of myocardial infarction?
Complete block of the coronary arteries due to thrombosis from rupture atherosclerotic plaque
Are the symptoms of MI relieved by nitroglycerin?
No
What parts of the heart are affected with LAD occlusion?
Anterior Wall
Anterior Septum
What parts of the heart are affected with Right coronary artery occlusion?
Posterior Wall
Posterior Septum
What parts of the heart are affected with Left Circumflex artery occlusion?
Lateral Wall of LV
What is generally not affect by MI?
Right Ventricle
What is the most common type of infarction?
Transmural
What is used to diagnose MI?
Troponin I in the blood - peaks at 24 hrs
What is the use of CK-MB as a marker?
It can detect recurrent MI as it will go down in 3 days
What is used to treat MI?
Nitrates Beta Blockers ACE-I O2 Aspirin or Heparin
What are the complications of reperfusion via fibrinolysis after an MI?
- Contraction Band Necrosis
- Reperfusion Injury
Why would enzymes increase after the administration of fibrinolysins?
Reperfusion injury will cause further release of enzymes
MI 4-24 hrs - Complication
Coagulative Necrosis - Arrhythmia
MI 1-3 days - Complication
Neutrophils - Fibrinous Pericarditis
MI 4-7 days - Complication
Macrophages - Rupture
MI 1-3 wks - Complication
Granulation
MI 1 month and beyond - Complication
Scar Formation - Aneurysm and Dressler Syndrome
Dressler Syndrome
Rare but inflammation of pericardium can cause pericarditis that occurs 6-8 weeks after MI due to autoimmune antibodies
