Cardiac Consequences of Atheroma

Question 1

Outline the timeline of Atherosclerosis

Answer 1

1. Fatty streaks formation, leading to an intermediate lesion
2. Fibrous cap forms on top of fatty streak, and core of lesion becomes necrotic
3. Thinning and rupture of fibrous cap occurs
4. Thrombus formation and arterial occlusion

Question 2

An ECG sign for subendocardial (partial) infarct is what?

Answer 2

ST depression

Also known as Non-STEMIs

Question 3

What is a Myocardial Perfusion Scan?

Answer 3

Nuclear imaging scan to see which parts of the heart are not as perfused during stress versus rest

Question 4

Is Troponin sensitive for MI? Is Troponin specific for MI?

Answer 4

It is sensitive, but not specific for MI. Other conditions will increase Troponin levels

Question 5

What are the treatments for STEMIs?

Answer 5

• Primary percutaneous coronary intervention (PCI)

- Thrombolysis

Question 6

What are the treatments for NSTEMIs?

Answer 6

• Antiplatelets
• Anticoagulants i.e. Heparin
• Statins
• Anti-ischaemics i.e. Beta-blockers, nitrates

Question 7

What does the Left Anterior Descending (LAD) artery supply?

Answer 7

Anterior wall and septum of left ventricle

Question 8

What does the Right Coronary Artery (RCA) supply?

Answer 8

Posterior wall, septum and papillary muscles of left ventricle

Question 9

What does the Left Circumflex Artery (LCX) supply?

Answer 9

Lateral wall of left ventricle

Question 10

An ECG sign for a Transmural Infarct (full thickness) is what?

Answer 10

ST elevation

Question 11

What are some complications of MIs?

Answer 11

• Arrhythmias
• Pericarditis
• Myocardial rupture
• Heart failure