Atherosclerosis, Angina, and Ischemic Heart Disease Flashcards
Atherosclerosis
- Atherosclerosis is a chronic inflammatory response to damage to endothelial cells (endothelial cell dysfunction), which is the initial and key event that leads to the formation of atherosclerosis.
Fatty streaks in the development of atherosclerosis
Fatty streaks, which are the earliest lesions of atherosclerosis and can be seen as early as the second decade of life
-formed by lipid-laden macrophages (foam cells) in the intima.
Grossly fatty steaks appear as small, flat, yellow-white discolorations with irregular borders.
Blue toe syndrome
- Blue toe syndrome, which is a known complication of vascular interventions and anticoagulant therapy
-caused by cholesterol emboli.
Livedo reticularis, a blue toe, and acute kidney injury following coronary angiography is suggestive of a cholesterol embolization syndrome.
Vasospastic angina
Patients with vasospastic angina (aka Prinzmetal angina or atypical angina) are usually young, without significant risk factors for coronary artery disease
-experience recurrent episodes of chest discomfort that typically occur during rest or sleep and resolve within 15 minutes.
What is the most common mechanism of sudden cardiac death following MI?
- Ventricular fibrillation is the most common mechanism of sudden cardiac death that occurs within one hour after a myocardial infarction.
Papillary muscle rupture
-Papillary muscle rupture is a life-threatening complication that typically occurs 3-5 days after MI and presents with acute mitral regurgitation and pulmonary edema.
-Papillary muscle rupture can cause acute mitral regurgitation, which can lead to a new holosystolic murmur along with signs of cardiogenic shock.
Dressler syndrome
Dressler syndrome (postcardiac injury syndrome)
-autoimmune response to cardiac antigens
-characterized by fibrinous pericarditis
-develops 1 to 3 weeks following an myocardial infarct.
Dressler syndrome is characterized by features of acute pericarditis such as fever, tachypnea, chest pain that worsens during inspiration and is alleviated by leaning forward, and a pericardial friction rub.
Hibernating myocardium
Hibernating myocardium refers to the presence of left ventricular systolic dysfunction due to reduced coronary blood flow at rest that is partially or completely reversible by coronary revascularization.
ID
Cholesterol clefts (center clearing)
Progression of atherosclerosis
NSTEMI
Coronary artery disease
Histologic changes following MI (observable by light microscopy) and their corresponding time frames
Most important clinically is period 5-10 days post MI (greatest risk for rupture and death - infarcted tissue is maximally soft)
Contraction bands
Most common infarct that presents with papillary muscle rupture as sequelae?
