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Pathophysiology 1 > Cardiac 1 > Flashcards

Cardiac 1 Flashcards

1
Q

What is the function of coronary arteries?

A

They deliver O2 rich blood to the myocardium

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2
Q

There are 2 main coronary arteries, what are they

A

The left coronary artery and the right coronary artery

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3
Q

The left coronary artery divides into 2, what are the names of these

A

Left anterior descending coronary artery and left circumflex

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4
Q

The left descending coronary artery supplies blood to which part of the heart?

A

The anterior walls of the left ventricle and supplies the inter-ventricular septum

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5
Q

What is another name for the left anterior descending?

A

The widow maker

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6
Q

What part of the heart does the left circumflex feed?

A

The lateral walls of the left ventricle

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7
Q

What does the right coronary artery feed?

A

The right atrium, right ventricle, inferior portion of the left ventricle, also supplies the SA and AV node

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8
Q

The posterior descending artery can originate from which coronary artery?

A

Can originate from the RCA or LCx

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9
Q

What does the posterior descending artery supply?

A

The posterior portion of the heart

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10
Q

What does the posterior descending artery supply?

A

The posterior portion of the heart

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11
Q

How do coronary arteries get their blood flow?

A

They get their blood flow during diastole from a back flow of low pressure

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12
Q

What is mitral stenosis?

A

The stiffening of the mitral valve in which it does not open properly

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13
Q

What does mitral stenosis cause?

A

Back pressure in the left atrium

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14
Q

What will happen long term with mitral valve stenosis?

A

Eventually the left side will undergo hypertrophy and will result in pulmonary hypertension and cause left sided heart failure

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15
Q

What heart sound would you expect to hear with a patient that is suffering from mitral stenosis

A

A low pitched rumbling and opening snap

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16
Q

What is mitral valve prolapse?

A

The cusps of the mitral valve do not close properly and bulge into the left atrium

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17
Q

What is mitral regurgitation

A

The mitral valve does not close properly allowing blood to leak back into the left atrium

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18
Q

What are the effects of mitral regurgitation?

A

Changes in preload and after load and can lead to hypertrophy of both chambers on the left side again causing left sided heart failure

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19
Q

What heart sound would you expect to hear from a patient suffering from mitral valve prolapse?

A

A mid systolic click

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20
Q

What heart sound would you expect to hear from a patient who is suffering from mitral regurgitation

A

A high pitched blowing sound aka a murmur

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21
Q

What is aortic stenosis

A

Stiffening of the aortic valves and they do not open up correctly

22
Q

What does aortic stenosis result in?

A

Pressure builds up in the ventricles therefore it will result in ventricular hypertrophy, left sided heart failure, and obstruction to aortic outflow

23
Q

What results from aortic regurgitation

A

A decrease in cardiac output and an increase in EDV

24
Q

What heart sound would you expect to hear in a patient who is suffering from aortic regurgitation

A

A high pitched blowing murmur with a bounding pulse

25
What are some vaso-dialatory substances
- adenosine - hypoxemia, hypercapnea, acidotic - potassium - protiglandins - nitric oxide
26
What is the ST segment, what does this segment represent
It’s the ending of the QRS to the beginning of T. It represents that the ventricles are fully depolarized
27
What is the QT interval and what does this represent?
The beginning of the QRS and the ending of T, it represents ventricular depolarization and depolarization.
28
What is the TP segment
The end of T to the beginning of P, this is the resting state before the next heart beat
29
What is the U wave?
The repolarization of the purkinjie fibers
30
What is zone 1 of infarction
It is infarction itself and it is an area of the myocardium that has undergone irreversible cell damage due to prolonged ischemia. Necrosis occurs and tissue can not be saved
31
What is zone 2 of infarction
This is hypoxic injury. Myocardial tissue has experienced severe hypoxia however cells are still viable but they are at risk of infarction is oxygen delivery is not restored.
32
What is zone 3 oof infarction
This is the ischemic zone, an area of thee myocardium is experiencing reduced blood flow and is at risk for further damage if blood flow is not restored
33
Myocardial stunning
This is temporary/reversible impairment of myocardial function. It is the healing break the myocardium needs after it has been through a ischemic/reperfusion injury
34
How long does myocardial stunning last?
Hours to days until normal myocardial function ie. contractility, returns
35
Hibernating myocardium
Myocardial tissue has a chronically reduced contractile function due to persistent ischhemia or CAD. Hibernating myocardium remains viable but dysfunctional. Restoration of normal blood flow will let the myocardium regain its normal function
36
What can myocardial remodelling negatively result in?
Ventricular dilation, hypertrophy, fibrosis, impaired contractility, which can all possibly contribute to heart failure
37
What are the three steps in the progression of an infarction
1. Infarct extension (hours) 2. Infarct wound healing / infarct expansion (hours to days) 3. Progressive cardiac remodelling (weeks to months)
38
What is infarct extension
In this step, is the enlargement and progression of an MI. This occurs if ischemia event is not promptly treated or if there is ongoing ischemia
39
What is infarct wound healing?
This is the process of wound healing after an MI. First there is inflamation, then the formation of granulated tissue.
40
What is infarct expansion?
This refers to the stretching/thining of infarcted area during the healing process
41
What is stable angina?
This is chest pain that is typically caused my exertion or stress and temporary ischemia due to narrowed coronary Arteries because of atherosclerosis
42
What is pinzemetal angina
This is chest pain that results from coronary artery vasospasm which can even happen while you are at rest
43
Sudden cardiac death
This is an unexpected death due to a cardiovascular cause that occurs within one hour of onset of symptoms
44
What is unstable angina
Can occur at rest and lasts longer and can become more severe overtime. It occurs as a result of a partial blockage of a coronary artery and can develop into a complete blockage
45
Acute myocardial infarction
Occurs when there is prolonged ischemia to the heart leading to tissue death.
46
AMI’ s can be further classified into two types based on ecg findings….
STEMI and NSTEMI
47
What determines the severity of a MI
1. Level of occlusion 2. Length of time of the occlusion 3. Collateral circulation
48
What is collateral circulation
It is the development of alternative blood vessels and pathways that can supply blood . MI severity depends on how well and effective these pathways are
49
What are lab tests that can be performed to help diagnose AMI
- troponin - CK-MB - Myoglobin
50
How does troponin help us diagnose AMI
Troponin is a protein found in myocytes. When there is a MI, troponin is released into the blood stream
51
How does CK-MB help diagnose AMI
CK-MB is and enzyme found in the cardiac muscle sells and is released in the blood stream following myocardial injury
52
How can myoglobin help diagnose AMI
Myoglobin is a protein found in cardiac and skeletal muscle cells, it too is also released into the blood stream following myocardial injury. However myoglobin lacks specificity

Pathophysiology 1 (9 decks)

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