form of acute coronary syndrome reversibel myocardial ischaemia due to sevre blockage

Myocyte Necrosis Prolonged Ischaemia

Cardiac Flashcards by Faysal Soufi

Define COD

Atheroma Formation in the Coronary Arteries

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What is a main cause of CHD?

Myocardial Ischaemia

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Unmodifiable Risk Factors for an Atheroma

Increasing Age
Sex
Genetics

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Modifiable Risk Factors:

Smoking
Hypertension
Obesity

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How is Increasing Age a risk factor for an atheroma?

Loss of ability to repair endothelial damage
Plaque matuaration

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Define Dyslipidaemia

abnormal concentrations of serum lipoproteins and triglycerides

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What are LDL’s

Deliver Cholesterol from lipid stores to peripheral tissue

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What are HDL’s

Transport cholesterol from peripheral tissues to the liver for excretion

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How is Smoking a Risk Factor?

Toxic Chemicals contribute to impaired cellular function-inflammation-injury

Increases Vasomotor Tone

Increases platelet aggreation and adhvesivenss

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How is Hypertension a risk factor?

140/90 risk factor

Increases sheer stress in vessels-damage to endothelium

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How is Diabetes a Risk Factor?

2 times the risk for AMI

Insulin Resistance:
Pro-Inflammatory Spate
Hyperlipidaemia

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Metabolic Syndrome Criteria:

Visceral Obesity-
Low HDL’s
Insulin Resistance

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Discuss Plaque Structure

Fibrous Cap-cells and connective tissue matrix

Cells-macrophages-foam cells-smooth mm cells-lymphocytes

Connective Tissue Matrix- Collagen Fibres, Elastin-Proteoglycans

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what forms the centre of the plaque

necrotic mass of lipid

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How do Plaques damage?

Endothelial Damage
Chronic Inflammation

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Define Angina

Chest pain caused by myocardial infarction

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Complications of a Plaque

Thrombus Formation
Aneurysm

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Define Stable Angina

50-70 occulsion
gradula narrowing of the coronary artery lumen

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Actue Coronary Syndromes

umbrella term for unstable angina and acute myocaridal infartion
* due to thrombus foramtion over a ruptured or ulcreaed arthoscletoic plaque

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Unstbale Agina

form of acute coronary syndrome reversibel myocardial ischaemia
due to sevre blockage

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What is it AMI

Myocyte Necrosis
Prolonged Ischaemia

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Site-Quality-Radiations-Agg-Rel Factors for Stable Angina

Central Chest
Compresive/Sqeezing
Arms-Left
Exercise-Emotional Stressors Agg
Rest, anti-anginal med Rel

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Ssx of Stable Angina

Dyspnoea-Palipations-Pallor-Nausea-Sevre Fatigue

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Most Cardiac Nociception accompany?

Sympahtetic Fibres

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Un-Stable Angina Signs

Occurs at Rest New Onset Increasing in Intensity, Duration or Frequency

Cause of Actute MyoCaridal Infarction

Ulcertation/ruputre of the plaque-thormbosis

Classic Presentation of AMI

Sevre RetroSternal Pain Radiation PAttern to Angina

Ssx of AMI

Dyspnoea-Pallor-Nausea Tachycardia-tachypnoea

Complications of AMI

Heart Failure-Arrythmias-Percarditis

Define Hypertension

Consistent elevation of Systemic Artieal Blood Pressure

Blood Pressure Rating

120-129-less than 80 High-130/80/84 Grade 1-mild 140-159-90-99 Grade 2-moderate-160-179-100 Grade 3 severe-180-110

Risk Factors for Primary HTN

* Family History * Advancing Age * SMoking * Obesity

Causes of Secondary HTN

Renal Disease Endocrine Disease

Pathological Vessel Changes

* Increased atheroma * Development of arteirolosclerosis

Clinical Features of HTN

Heaache potenially No early ssx

Complications of HTN

AMI Stroke Aortic Aneurysm

Pharmacological Managment of HTN

* Beta Blockers * Diuretics * ACE inhibtors * Angiotensin 2 Receptor Blockers * Calcium Channel Blockers

Define Stenosis

valve is less flexible and produces resistance to normla blood flow

Regurgtion Define

valve that cant close completey and allows blood to pass back through it

Common Aetiologies of Vavular Disorders

* Cogential Valve Deformitiy * Degenerative changes with ageing-hypertension * Infection`

Systolic Murmur is heard when there is?

Aortic Stenosis

Diastolic Murmur is heard when there is?

Aortic Regurgitation

Mitral Stenosis results in?

Diastolic Murmur

Mitral Reguritation causes

Systolic Murmur

In a case Stenosis the murmur will occur when the valve is?

Open

In the case of Regurgitation the murmur are heard when the valve is?

Closes

Artial Fibrillation Define

Abnormality of rate, regularity site of impulse origin or sequence of depolarisation

Disorers of Impulse Formation is from the?

SA Node

Disorders of impulse conduction are through?

Conducting system of the heart

Risk Factors of Artial Fibrillation

* Family History * Obesity * Alcohol-Caffiene

PathoPhysiology of AF

ectopic signals orginating from pace-maker cells within the atria

Clincal Features of AF

Papitations-Dyspnoea-Weakness/fatige Hypertension-Angina

Pharamcoloigcal Managament of AF

Rate Control Rhytm Anti-Coagulant

Define Heart Failure

Gradual Failure to Main C.O despite normal blood volume

Systolic Failue refers to?

Inability of the heart to generate an adquete Cardiac OutPut to perfuse vital organs

Diastolic Failure Refers to

decreaed compliacne of the Lt Ventricle

What can Diastolic failure lead to?

if pressure is reflected back into the pulomary circulation it can lead to pulmonary oedema

Cause of LEFT Side Heart Failure

AMI Hypertension Aortic/Mitral Valve Disease

# r Aeitoloy of right Heart heart failure

Left Sided Heart Failure Pulmonary Lung Disease Pulomary-Tricuspid Valve Disease

Sustained Systemic HTN afects?

the afterload

What are problems with the Left Ventricle undergoign remodelling?

Ischamia Disruption of Extra-Cellular Matrix Progressive dysfunction of contractile myocytes

Right Sided Failure affects?

afterload for the Rt Ventricle

Clinical Features of Heart Failure

Cardiomegaly-aptical heart beat * Features of Inadquete CO-Fatigue/weakness/chest pain/dizziness, Tachycardia * Swelling ankles and legs

4 general mechanisms to IDA

* loss or iron due to a bleeding * Inadequaute iron diet * Malabsoprtion * Increased Requirment

# * Who is at increased risk for HTN?

* Women in their productive years * GIT bleesing * Inadqeuete dietary inkae *

Pahtophysiology of IDA

RBc's become mircocytic Hypchromic

Anaemia Symtopms

fatigue, sob, diziness, palpitations

signs of anaemia

pallor of skin, mucous membrane, conjuctivae

IDA Clinical Features

thin,brittle nails red tongue dryness, corner of mouth

Why is b12/folate important

role in dna synthesis-b12 has intrinsic factor

PathoPhysiology of B12/Folate Defiency

interfers with DNA synthesis/mitosis Results in immaure RBC in circulation

Neurological Changes due to Vitamin B12-Defienceny

Traniset Paraesthia Irritability Reduced vibration-Positon sense Ataxia