cardiac ischaemia Flashcards
what is cardiac ischaemia?
what is stable angina?
what re acute coronary syndromes?
how do they occur - mechanisms?
how does sudden death occur in coronary disease?
risk factors for acute coronary syndrome?
hypertension, hyperlipidemia, FH (1* relative, M,50, F<60), smoking, obesity
what is transmural ischameia?
coronary vessel completely occluded and deprive entire thickness of myocardium of oxygen
what is subendocardial ischaemia?
classic ECG finding in subendocardial ischaemia?
ST depression
t wave inversion
causes of T wave inversion
classic ECG finding in transmural ischaemia?
ST elevation
what is this?
q wave, hours after STEMI
what are hyper acute T waves?
what is poor r wave progression?
what re the ischaemic pathologic changes seen in 0-4 hrs post MI?
none
what re the ischaemic pathologic changes seen in 4-12 hrs post MI?
gross = mottles
micro = necrosis, oedema, haemorrhage
what re the ischaemic pathologic changes seen in 12-24 hrs post MI?
gross = hyperaemia
micro = surrounding tissue inflammation
what re the ischaemic pathologic changes seen in 5-10 days post MI?
gross = central yellowing
micro = granulation tissue
what re the ischaemic pathologic changes seen in 7 weekss post MI?
gross= grey-white scar
micro = scar
what are complications of ischaemia in first 4 days?
arrhythmia
what are complications of ischaemia 5-10 days after?
free wall rupture
tamponade
papillary muscle rupture
ventricular septal rupture
what are complications of ischaemia weeks after?
dressler’s syndrome
aneurysm
LV thrombus/CVA
what is free wall rupture?
rupture of one of the walls of LV
usually fatal > sudden death
can lead to tamponade
what is papillary muscle rupture?
leads to acute mitral regurgitation (holosytolic murmur)
can develop HF, resp distress
more common in inferior MIS - posteromedial papillary muscle has single blood supply (RCA), can lead to necrosis and rupture of this muscle
what is Ventricular septal rupture?
loud holosystolic murmur with thrill
presents with hypotension, RHF, increased JVP + oedema
occurs because RV overloaded with blood from LV due to septal defect
what is ventricular aneurysm?
myocardial wall replaced with scar tissue
occurs weeks after mI
more common in anterior infraction
risk of thrombus>stroke + PE
what is ventricular pseudoaneruysm?
what is Dressler’s syndrome?
what is fibrinous pericarditis?
what are complications of stents?
restenosis
thrombosis
what is restenosis?
what is stent thrombosis?
