CAD Flashcards
What are the two main coronary arteries that arise from the SOV located at the proximal segment of the aorta just above the valve
Left main coronary
Right coronary
which of the two coronary arteries is the larger of the two and runs between the pulmonary trunk and left atrial appendage
Left main coronary artery
At the level of the sulcus the left main artery divides into what two branches?
Left anterior descending (LAD)
The Circumflex (CIRC)
What does the Lt anterior descending provide blood flow to
- anterior IVS
- anterior LV wall
- cardiac apex
What is a blockage/occlusion in the LAD termed as
Widowmaker
What does the circumflex artery supply
- Lt atrium
- posterior and lateral free walls of the Lt ventricle
- part of the anterior papillary msucle
What artery arises from the Rt SOV and runs along the Rt AV sulcus between the Rt atrial appendage and the pulmonary trunk
RIght Coronary Artery
What is the largest branch that the Rt coronary artery divides into
Posterior descending (PDA)
Rt coronary artery provides blood flow to:
- RA/Rt ventricle
- SA node
- AV node
Posterior Descending Artery provides blood flow to:
- Inferior walls of both ventricles and the inferior IVS
____ % of humans are right coronar artery dominate - meaning RCA supplies blood to ____
- 67
- Posterior descending artery (PDA)
if PDA is supplied by the circumflex it is Lt dominance
The myocardium is perfused from the….
epicardium to the endocardium
When is the myocardium mainly perfused
during diastole
Myocardial contraction during ____ compresses ____ branches and prevents perfusion.
- Systole
- Arterial
Therefore, coronary perfusion occurs during diastole rather than systole
What is the most common form of heart disease in adults
Coronary artery disease (CAD)
CAD clinical syndromes are the result of atherosclerotic disease of the coronary arteries and include:
- stable and unstable angina
- acute myocardial infarction
- ischemic cardiomyopathy w/congestive heart failure
- sudden cardic death
A restriction in blood supply to tissues, causing a shortage of oxygen is known as
ischemia
A stenosis (ischemia) can also cause:
A ventricular arrhythmia, which may turn into ventricular fibrillation leading to death
Can myocardial ischemia be reversed
yes, if the blood flow to the tissue is improved
When the narrowing exceeds __-__% of the luminal cross-sectional area, blood flow then becomes inadequate to meet the myocardial oxygen demands
70-90
When is it considered that the blood flow becomes inadequate to meet the myocardial oxygen demands?
when the narrowing exceeds 70-90% of the luminal cross-sectional area
When ischemia develops slowly collateral vessels can develop in the heart. These serve as ____ that bridge severe ______ or connect a territory supplied by one epicardial coronary arter with that of another.
- conduits
- severe
Collaterals provide:
-Alternative source of blood suply to myocardium jeopardized
- Can help to preserve myocardial function
What are risk factors for coronary artery disease?
- Age
- Sex
*men are generally at greater risk but risk for women increases after menopause - Family history
- Smoking
- High blood pressure
Family history
Your risk is highest if your ____ or ____ was diagnosed w/heart disease before age 55, or your mother or sister developed it before age ____
- father or brother
- 65
Smoking
Nicotine constricts your blood vessels, and carbon monoxide can damage the inner lining, making it more susceptible to …
atherosclerosis
What can uncontrolled high blood pressure result in
hardening and thickening of your arteries
Over time, a higher workload leads to…
an enlarged heart/LVH
Cholesterol
What are the symptoms of CAD
- Chest pain/Stable and Unstable angina
- ECG changes
- Shortness of breath
What is stable angina?
- Chest discomfort from increase activity
- Predictable chest discomfort associated w/ physical exertion or mental or emotional stress
What relieves stable angina
rest and/or nitroglycerin
Unexpected chest pain that usually occurs at rest is known as
unstable angina
-Typically more sever and prolonged
Unstable angina is an acute coronary syndrome and should be treated as an emergency
Ways to prevent CAD
- decreasing cholesterol levels
- addressing obesity and HTN
- avoiding a sedentary lifestyle
- healthy dietary choices - no smoking
- lower blood pressure
- limit alcohol
- keep blood sugar under control
- reduce stress
What is a cluster of cardia risk factors that result from insulin resistance?
Syndrome X - Metabolic syndrome
Syndrome X - Metabolic Syndrome is diagnosed if three of the following are diagnosed…
- Elevated waist circumference
- Elevated serum triglycerides
- Elevated blood pressure
- Elevated fasting glucose
- Reduced high-density lipoprotein cholesterol
True or false, women are more likely than men to suffer from Syndrome X
True
What are the medical treatments fro CAD
- Aspirin - can reduce teh incidence of cardiovascular events
- Anti-platelet therapy (plavix)
- Nitroglycerin
- Cholesterol lowering medications
- Blood pressure medications
What are some more serious treatments for CAD
- Angioplasty
- Coronary stent-implantation
- Coronary artery bipass grafting (CABG)
