CAD

Question 1

Pathology of slow narrowing

Answer 1

Atherosclerosis of coronaries- Rigid, calcified. Narrowed due to fibrotic plaques & atheromas. Ca++ salt & Cholesterol deposits present.
Ischemia–CHF

Question 2

Pathology of acute thrombosis

Answer 2

MC in arteries already narrowed by atherosclerosis

Sudden occlusion=MI

Question 3

Location of occlusion

Answer 3

1. 50% LAD–Anterior wall LV
2. 30-40% RCA–RV & Posterior wall LV
3. 10-20% L circumflex–Lateral/Free wall LV

Question 4

Acute MI causes

Answer 4

Sudden occlusion by:

1. Thrombosis (80-90% of transmural MI)
2. Ulceration of embolized plaque
3. Prolonged vasospasm

Question 5

Cause of sudden death after MI

Answer 5

25% sudden death

1. Most=arrhythmias (VFib)
2. Complete heart block
3. CHF later on

Question 6

Complications if survive

Answer 6

75% survive
1. CHF
2. Cardiogenic shock–decreased perfusion–multiorgan failure
Most dangerous=Cerebral ischemia

Question 7

Types of MI

Answer 7

1. Transmural=all 3 layers
   Involves free wall LV &/or septum
   3 complications
2. Subendocardial/Intramural=concentric around subendocardial layer
   1/2 of the tissue layer is still viable

Question 8

Complications of transmural MI

Answer 8

1. LV aneurysm
2. LV rupture
3. Mural thrombus–CVA