Cardiac Pathology (Part 1) Flashcards
what is synonymous with CAD?
ischemic heart disease
what is a right dominant heart?
a heart in which the right coronary artery supplies the posterior descending artery
what does the posterior descending artery supply?
the AV node
what are the most sensitive and specific biomarkers of myocardial damage?
troponin T and I
which composition of creatinine kinase is specific to cardiac muscle?
ckMB
when do levels of troponin I and T begin to rise?
3-12 hours after a MI
what MI biomarkers return back to baseline sooner?
ckMB
when does ckMB return back to baseline?
in 48-72 hours
when does troponin return back to baseline?
within 5 days
occlusion of the LAD causes infarction of what?
apex, LV anterior wall, and anterior 2/3 of septum
occlusion of the circumflex artery causes infarction of what?
LV lateral wall
occlusion of the right coronary artery causes infarction of what?
the RV free wall, LV posterior wall, and posterior 1/3 of septum
when can a subendocardial infarct occur?
after a reperfusion of transmural infarct (regional) or after global hypotension (circumferential)
when might you seen multifocal microinfarction?
embolic disease or in cocaine use
what is the first histologic change seen in MIs?
there is a slight waviness of the fibers at the border
what are the histologic changes that occur 4-12 hours after a MI?
very early coagulation necrosis and edema
what are the histologic changes that occur 12-24 hours after a MI?
coagulation necrosis increases; pyknosis; hypereosinophilia
what are the histologic changes that occur 1-3 days after a MI?
coagulation necrosis with loss of nuclei and striations; brisk infiltration of neutrophils
what are the histologic changes seen 3-7 days after a MI?
macrophages
when does scar tissue begin to be laid down following an MI?
after 2 weeks
when does LDH leak out of dead myocytes?
after 2-3 hours
when is the scar complete following an MI?
after 2 months
what is contraction band necrosis?
with reperfusion, an influx of calcium causes the sarcomeres to contract
when do the early complications associated with MIs occur?
within the first 24 hours
what are the early complications associated with an MI?
life threatening arrhythmia and contractile dysfunction (shock)
when do the intermediate complications associated with an MI occur?
from the 2-4 day mark onward up to 2 weeks
what are the intermediate complications associated with an MI?
rupture of the free wall, septum, or papillary muscles; acute fibrinous pericarditis
when do the late complications associated with an MI occur?
after 2 weeks
what are the late complications associated with an MI?
chronic pericarditis (Dressler syndrome); ventricular aneurysm; continued risk of heart failure, life threatening arrhythmia
what is the most common cause of death due to MI?
fatal arrhythmia
rupture of the free wall can lead to what?
blood accumulating in the pericardial space
what can papillary muscle rupture lead to?
valve incompetence and post infarct regurgitation
