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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
Q

What are some vaso-dialatory substances

A
  • adenosine
  • hypoxemia, hypercapnea, acidotic
  • potassium
  • protiglandins
  • nitric oxide
26
Q

What is the ST segment, what does this segment represent

A

It’s the ending of the QRS to the beginning of T. It represents that the ventricles are fully depolarized

27
Q

What is the QT interval and what does this represent?

A

The beginning of the QRS and the ending of T, it represents ventricular depolarization and depolarization.

28
Q

What is the TP segment

A

The end of T to the beginning of P, this is the resting state before the next heart beat

29
Q

What is the U wave?

A

The repolarization of the purkinjie fibers

30
Q

What is zone 1 of infarction

A

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
Q

What is zone 2 of infarction

A

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
Q

What is zone 3 oof infarction

A

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
Q

Myocardial stunning

A

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
Q

How long does myocardial stunning last?

A

Hours to days until normal myocardial function ie. contractility, returns

35
Q

Hibernating myocardium

A

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
Q

What can myocardial remodelling negatively result in?

A

Ventricular dilation, hypertrophy, fibrosis, impaired contractility, which can all possibly contribute to heart failure

37
Q

What are the three steps in the progression of an infarction

A
  1. Infarct extension (hours)
  2. Infarct wound healing / infarct expansion (hours to days)
  3. Progressive cardiac remodelling (weeks to months)
38
Q

What is infarct extension

A

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
Q

What is infarct wound healing?

A

This is the process of wound healing after an MI. First there is inflamation, then the formation of granulated tissue.

40
Q

What is infarct expansion?

A

This refers to the stretching/thining of infarcted area during the healing process

41
Q

What is stable angina?

A

This is chest pain that is typically caused my exertion or stress and temporary ischemia due to narrowed coronary Arteries because of atherosclerosis

42
Q

What is pinzemetal angina

A

This is chest pain that results from coronary artery vasospasm which can even happen while you are at rest

43
Q

Sudden cardiac death

A

This is an unexpected death due to a cardiovascular cause that occurs within one hour of onset of symptoms

44
Q

What is unstable angina

A

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
Q

Acute myocardial infarction

A

Occurs when there is prolonged ischemia to the heart leading to tissue death.

46
Q

AMI’ s can be further classified into two types based on ecg findings….

A

STEMI and NSTEMI

47
Q

What determines the severity of a MI

A
  1. Level of occlusion
  2. Length of time of the occlusion
  3. Collateral circulation
48
Q

What is collateral circulation

A

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
Q

What are lab tests that can be performed to help diagnose AMI

A
  • troponin
  • CK-MB
  • Myoglobin
50
Q

How does troponin help us diagnose AMI

A

Troponin is a protein found in myocytes. When there is a MI, troponin is released into the blood stream

51
Q

How does CK-MB help diagnose AMI

A

CK-MB is and enzyme found in the cardiac muscle sells and is released in the blood stream following myocardial injury

52
Q

How can myoglobin help diagnose AMI

A

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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