Cardiac 1 Flashcards
Hallmark of Stable angina on EKG
ST segment depression
Stable Angina only when atherosclerosis is ____ (number)
> 70% stenosis (from atherosclerosis) of coronary arteries
Definition of Unstable Angina
Chest pain at rest
due to rupture of atherosclerotic plaque with thrombosis and incomplete occlusion of coronary artery
Prinzemetal Angina is
Vasospasm of coronary artery
episodes of chest pain unrelated to exertion
Possible causes of Myocardial Infarction
rupture of atherosclerotic plaque with thrombosis and COMPLETE occlusion leading to necrosis of myocytes
Prinzemetal vasospasm for greater than 20 minutes
Embolism
Vasculitis (inflammation > thrombus)
Marker for MI
Troponin I
rises 2-4hr after infarction
peaks @ 24hrs
returns to normal by 7-10 days
What marker is useful for detecting re-infarction a couple days after initial episode?
CK-MB
rises 4-6hrs after infarction
but returns to normal by 72hrs unlike Troponin I
Treatments for MI
ASA/heparin supplemental O2 Nitrates (reduces preload) Beta blocker (prevents arrhythmia) ACE inhibitor (prevents water retention)
Fibrinolysis or angioplasty can cause Contraction Band necrosis. What is it?
Sudden repurfusion introduces Ca++ which causes contraction of necrotic tissue. Histologically, it’s bands in myocytes
Symptoms of pulmonary congestion
Edema Dyspnea Orthopnea Paroxymal nocturnal dyspnea Orthopnea Crackles
What causes Heart Failure Cells
Left sided heart failure leads to excess blood in pulmonary circulation. Rupture of capillaries leads to blood in alveoli air sacks. Macrophages consume that blood and will become HEMOSIDERIN LADEN MACROPHAGES aka Heart Failure Cells
Cor Pulmonale is…
Due to
Right sided heart failure due to pulmonary blood vessels constricting due to hypoxia in the lungs.
Jugular Vein Distention due to
Right side heart failure
Cardiac congestion symptoms
JVD
Hepatosplenomegaly (painful)
Cardiac Cirrhosis
Pitting Edema
Most common type of Atrial Septal Defect
Ostium Secundum
What is paradoxical embolism?
Emboli in the Vena Cava would usually travel into the pulmonic circulation and lodge there. But in ATRAIL SEPTAL DEFECT it would travel through the the septum into the left atrium, then ventrical, and lodge elsewhere in the body, such as the brain.
Patent Ductus Arteriosis associated with
Congenital Rubella
Patent Ductus Arteriosis links what with what?
Pulmonary Artery with Aorta (below major upper body arteries)
Pulmonary hypertension will result in shunting of blue blood from pulmonary circulation into aorta, which results in lower body cyanosis.
What is Eisenmenger syndrome?
Reversal of a Left to Right shunt due to pulmonary hypertension
Treatment for PDA (patent ductus arteriosis)
Indomethacin
Decreases Prostaglandin E, which is what keeps the duct open
Closes the PDA
Boot shaped heart associated with
Tetralogy of Fallot
Transposition of Great Vessels associated with
Maternal diabetes
Coarctation of the Aorta is…
associated with ____
Narrowing of aorta distal to aortic arch but proximal to PDA
presents with lower extremity cyanosis
associated with Turner Syndrome
Coarctation in adults results in
Since no patent duct, results in Hypertension in upper extremities Hypotension in lower extremities Collateral circulations develop across intercostal arteries results in NOTCHING of BONE (on xray)
