Cardiac pt 2 Flashcards
what can identify coronary plaque burden or vulnerable plaques
MRI
CT
what is chronic ischemic cardiomyopathy typically due to
slow, progressive ddeath of myocytes from chronic ischemia
what is the most common cause of CHD
atherosclerosis
if you want to assess the L side of the heard with a catheter, what artery do you insert it in
brachial artery (goes to aorta)
what type of angina is unrelated to causes of increased myocardial oxygen demand
prinzmetal/vasospastic
what do st segment changes indicate
injury and ischmeia
what does a coronary angiography do
visualizes coronary arteries with florescent dies
patients with transient myocardial ischemia present clinically with:
stable angina pectoris
ischemic cardiomyopathy
what type of angina is characterized by a fixed coronary obstruction blocking response to increased O2 demand
stable
how does atherosclerosis cause cardiac ischemia
thrombus formation
coronary vasospasm
endothelial cell dysfunction
what are acute coronary syndromes
acute changes in plaque morphology
what are the 3 ECG changes indicating and MI
ST depression
ST elevation
T wave inversion
what do people with ACS present with
unstable angina
myocardial infarction
what were MIs and unstable angina typically distingused by
the prescence of absense of serum biomarker levels
what arteries does atherosclerosis typically develop in
large and medium sized arteries
what are some isoforms that are released when cardiomyocytes are damaged
CK-MB
troponin
what is a STEMI
total occlusion of main coronary BV
elevated levels of what is a highly specific indactor of MI
CK-MB
what is cardiac ischemia
oxygen supply is insufficient to meet metabolic demands
what are the 3 patterns of angina pectoris
stable/typical
vasospastic/prinzmetal
unstable/crescendo
what are some signs an symptoms of MI
pain
nausea
diaphoresis
vomiting
if the ECG shows an st elevation, it is a
STEMI
what test can provide estimations of EF and ventricular sys and dia function
echocardiography
what do you need to identify acute and chronic MI
contrast media with MRI
what are chronic coronary syndromes typically due to
chronic obstruction from STABLE atherosclerotic plaques
who would normally have chronic ischemic cardiomyopathy
elderly individuals
what test can show an image of cardiac structure and motion within the chest
echocardiography
what test uses electrodes
electrocardiography
when does significant blood flood reduction occur with atherosclerosis
when plaque occupies over 75% of vessel lumen
what can an MRI identify
myocardial thickening
valve structures
congenital malformations
what is chronic ischemic cardiomyopathy
heart failure that develops due to progressive ischemic myocardial damage
if the ECG shows no st elevation and is positive for biomarkers, it is a
NSTEMI
what test is useful for imaging cardiac structures
MRI
CT
what does cardiac catheterizaton directly measure
pressure within cardiac chambers
if you want to assess the R side of the heart with a catheter, what artery do you insert it in
femoral (goes to inferior vena cava)
what test uses reflected sound waves
echocardiography
what are some non-modifiable risk factors for coronary heart disease
age
gender
family history
ethnicity
what is a NSTEMI
a partial occlusion of main coronary BV
what is the treatment for STEMI
acutre reperfusion therapy and fibrinolytics
what are some modifiable risk factors for coronary heart disease
lipid
non-lipid (hypertension, smoking)
obesity
poor diet
sedentary lifestyle
what is the treatment for an unstable angina
percutaneous coronary intervention
what scan can evaluate cardiac perfusion
SPECT
what are the two maintreatment goals for an MI’s ischemia
increase myocardial O2 supply
decrease myocardial workload
what are the MI compensatory responses
increase SV and maintian CO
what is the primary cause of sudden cardiac death
lethal dysrhythmia
what is prinzmetal angina relieved by
calcium channel blockers - inhibit muscle contraction
what is CHD characterized by
insufficient flow of oxygenated blood to the myocardium due to atherosclerotic coronary arteries
if the ECG shows no st elevation and is negative for biomarkers, it is a
unstable angina
what are the 3 primary indicators of an MI
signs and symptoms
ECG changes
serum biomarkers
what do st elevation indicate
acute cellular injury - ischmeia and injury ongoin
what is stable angina relived by
nitrates
rest
what test provides a graphic illustration of the electrical currents
electrocardiography
what type of angin is unpredictable
prinzmetal/vasospastic
what type of angina is predictable
stable
what is the sequelae of CHD
angina pectoris
myocardial infarction
dysrhythmia
heart failiure
sudden cardiac death
what are the two critical factors affecting cellular demand for O2
rate of coronary perfusion
myocardial workload
cold spots in nuclear cardiography indicate what
inadequate perfusion
what is angina pectoris
intermittent chest pain
what test assesses the adequacy of blood flow to cardiac tissues
nuclear cardiography
what are the 5 steps of atherosclerosis
chronic endothelial injury
endolthelial dysfunciton
macrophage activation
macropahge/SM cells engulf lipid
SM proliferation
most cases of sudden cardiac death are associated with
coronary atherosclerosis
what is angina pectorsi precipitated by
increased O2 demand
how does nuclear cardiography work
radioactive substances are injected into the bloodstream to trace the patterns of blood flow
