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2 - CPR (cardio) > Cardiac Path Part 1 > Flashcards

Cardiac Path Part 1 Flashcards

1
Q

What is the most common heart disease and the leading cause of death in heart diseases?

A

Coronary Artery Disease

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2
Q

What are the 2 common types of Ischemic Heart Disease (CAD)?

A

Myocardial Infarction

Angina

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3
Q

What are the risk factors for Ischemic Heart Disease (CAD)?

A

Increasing age - Males
Hypertension and Hyperlipidemia (LDL)
Smoking and Diabetes

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4
Q

What usually causes Ischemic Heart Disease?

A

Atherosclerosis

Coronary A. Emboli

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5
Q

What is the most common site of Coronary Artery Disease?

A

LAD

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6
Q

What determines dominance in the heart?

A

Supply of lower posterior heart through the Posterior Descending Artery

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7
Q

The Posterior Descending Artery supplies the ___ node

A

AV node

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8
Q

The posterior descending artery determines?

A

Dominance

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9
Q

Right Dominant Heart

A

The right coronary provides the Posterior Descending Artery and supplies the lower posterior heart

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10
Q

Left Dominant Heart

A

– less common

The left coronary provides the Posterior Descending Artery and supplies the lower posterior heart

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11
Q

Symptoms of Myocardial Infarction?

A
  • Crushing/stabbing/squeezing substernal chest pain
  • Radiates to shoulder, neck, jaw
  • Rapid, weak pulses and profuse sweating
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12
Q

Symptoms of Myocardial Infarction?

A
  • Crushing/stabbing/squeezing substernal chest pain
  • Radiates to shoulder, neck, jaw
  • Rapid, weak pulses and profuse sweating
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13
Q

What are the most sensitive and specific biomarkers of myocardial damage?

A

Troponin T and i

cTnT and cTnI

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14
Q

What are the most sensitive and specific biomarkers of myocardial damage?

A

Troponin T and i

cTnT and cTnI

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15
Q

What is a sensitive but NOT specific marker of cardiac injury?

A

Creatine Kinase

- MB Heterdimer (CKMB)

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16
Q

What is a sensitive but NOT specific marker for cardiac injury?

A

Creatine Kinase

- MB Heterodimers (CKMB)

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17
Q

What is the time to ELEVATION of CKMB, cTnT, cTnI with a MI?

A

3-12 hours with peak at 24 hours

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18
Q

Can a person be experiencing a MI without Troponin elevation?

A

YES – takes 3 hours for the troponins to elevate and MI symptoms can occur within 30 minutes

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19
Q

What is the time to NORMALIZATION for CKMB?

A

48-72 hours

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20
Q

What is the time to NORMALIZATION for cTnT and cTnI?

A

Longer than 5 days

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21
Q

What should you measure if you believe a person is having a MI but their troponins are not elevated?

A

Serial Troponins

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22
Q

LAD transmural infarct zone?

A

Apex and Anterior

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23
Q

Left Circumflex transmural infarct zone?

A

Left ventricle lateral wall

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24
Q

Right coronary transmural infarct zone?

A

Right and Posterior

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25
Q

With a MI, transmural infarcts are common. What is another pattern of injury and when does it occur?

A

= Subendocardial infarct
Occurs after:
1. Reperfusion of transmural infarct
2. Global hypotension

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26
Q

Reperfusion of transmural infarct that causes a subendocardial infarct is a ____ infarct

A

Regional

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27
Q

Global hypotension that occurs after a subendocardial infarct is a _____ infarct

A

Circumferential

28
Q

Morphologic changes with an Irreversible injury of the heart

- less than 4 hours?

A

Waviness of fibers

29
Q

Morphologic changes with an Irreversible injury of the heart

- 4-12 hours?

A

Edema and Coagulation necrosis

30
Q

Morphologic changes with an Irreversible Injury of the heart

- 12-24 hours?

A

Coagulation necrosis continues, Contraction band and increased eosinophils

31
Q

Morphologic changes with an Irreversible Injury of the heart

- 1-3 days?

A

Increased neutrophils and loss of nuclei

32
Q

What does the gross infarct look like on the heart after 1-3 days?

A

Yellow-tan infarct center

33
Q

Morphologic changes with an Irreversible Injury of the heart

- 3-7 days?

A

Disintegration of dead fibers by Macrophages

34
Q

Morphologic changes with an Irreversible Injury of the heart

- 7-10 days?

A

Granulation tissue at margins

35
Q

Morphologic changes with an Irreversible Injury of the heart

- 2 weeks and beyond?

A

Granulation tissue and Collagen Deposition

36
Q

At 2-8 weeks post irreversible injury of the heart, how will the infarct area look?

A

Gray-white scar

37
Q

Early complications of MI?

A
  1. Life threatening Arrhythmias

2. Contractile dysfunction

38
Q

An early complication of a MI is life threatening arrhythmias. When do they occur and what are they the #1 cause of?

A

Occur within 1 hour of the onset

- #1 cause of death

39
Q

An early complication of a MI is contractile dysfunction. What does that depend on and what does it lead to?

A

Depends on the size of the infarct

- Leads to cardiogenic shock within 24 hours of onset

40
Q

Intermediate complications of a MI?

A

Myocardial rupture

41
Q

When does a myocardial rupture occur and what are parts can rupture?

A

Occurs 2-4 days after a MI

- septal, papillary or free wall rupture

42
Q

What can a Myocardial rupture lead to?

A

Acute Pericarditis

fibrinous, serofibrinous

43
Q

Late complications of a MI?

A
  1. Dressler Syndrome
  2. Ventricular aneursym with life threatening arrhythmias
  3. Congestive Heart Failure
44
Q

Dressler Syndrome

A

Immune reaction to myocardial proteins in the blood
= Fever, pleuritic pain and pericardial effusion
– Late complication of MI

45
Q

Dressler Syndrome

A

Immune reaction to myocardial proteins in the blood
= fever, pleuritic pain and pericardial effusion
– late complication of MI

46
Q

How does a Ventricular Aneurysm arise?

A

MI -> Transmural infarct -> thin-walled scar -> aneurysm

47
Q

Angina Pectoris

A

Recurrent chest pain induced by myocardial ischemia that is insufficient to induce myocardial infarction

48
Q

Recurrent chest pain induced by myocardial ischemia that is insufficient to induce myocardial infarction

A

Angina pectoris

49
Q

3 types of Angina?

A

Stable Angina
Prinzmetal Variant Angina
Unstable Angina

50
Q

Stable Angina is caused by?

A

Stenotic occlusion of Coronary A.

** (+) by physical activity!

51
Q

What will trigger Stable Angina?

A

Physical activity or stress

52
Q

What will relieve the pressure/squeezing pain of Stable Angina and Prinzmetal Variant Angina?

A

Rest or vasodilators

53
Q

Prinzmetal Variant Angina is caused by?

A

Episodic Coronary A. spasm

54
Q

Is Prinzmetal Variant Angina triggered by physical activity?

A

NO - unrelated to activity, BP or HR

55
Q

Unstable Angina is caused by?

A

Rupture plaque with partial thrombus/occlusion

56
Q

When will Unstable Angina present?

A

AT REST

57
Q

What pattern of pain will be experienced with Unstable Angina?

A

Crescendo pattern

= Increasing severity or duration

58
Q

Unstable Angina and NSTEMI present due to partial occlusions. What will be present with a NSTEMI but not unstable angina?

A

Elevated troponins

59
Q

STEMI’s are ____ occlusions

A

Complete

60
Q

If a patient presents with stereotypical signs of a MI, what kind should be suspected?

A

STEMI

61
Q

If a MVC causes trauma to the heart, what will likely occur?

A

Cardiac contusion

62
Q

If a cardiac contusion is full thickness, what can occur?

A

Contusion rupture and blood goes into the pericardial space = cardiac tamponade

63
Q

If a cardiac contusion is full thickness, what can occur?

A

Contusion rupture and blood goes into pericardial space = cardiac tamponade

64
Q

Results of cardiac tamponade?

A

HYPOtension and possibly death because the heart cannot pump well

65
Q

Results of Cardiac Tamponade?

A

HYPOtension and possible death because the heart cannot pump well

2 - CPR (cardio) (44 decks)

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