Cardio-IHD Flashcards
Cornerstone in the diagnosis of acute and chronic ischemic heart disease
Electrocardiogram(ECG)
Most common underlying cause of myocardial ischemia and injury
Obstruction of coronary arteries by atherosclerosis
Infection associated with accelerated atherosclerosis
Chlamydophila pneumoniae
Most common cause of anterior chest musculoskeletal pain
Costochondral and chondrosternal syndromes
Myocardial perfusion occurs during this time
Diastole
Represents initial lesion of atherosclerosis
Fatty streak
Major features of metabolic syndrome
Central obesity Hyperglycemia Hypertriglyceridemia Hypertension Low HDL cholesterol
Age when lipid screening should start(based on current ATP III guidelines)
All adults >25 years(fasting lipid profile)
Repeated every 5 years
Key feature in metabolic syndrome
Central adiposity
Most accepted unifying hypothesis to describe pathophysiology of metabolic syndrome
Insulin resistance
Driving force behind the metabolic syndrome
Obesity
Most common cause of myocardial ischemia
Atherosclerotic disease of epicardial coronary artery
Most common vessel involved in MI
Left anterior descending artery
Sites of predilection for atherosclerotic plaques to develop due to increased turbulence
Branch points in the epicardial arteries
Time frame for reversible damage in myocardium
<20 minutes for total occlusion in the absence of collaterals
Most widely used test for both the diagnosis of IHD and estimating the prognosis
Electrocardiographic stress testing
Common pathophysiologic cause of unstable angina
Plaque rupture or erosion with super imposed non occlusivethrombus
Only absolute contraindication to nitrate use
Hypotension
Sildenafil(or similar drug) in previous 24hr
Most common artery involved in Prinzmetal angina
Right coronary artery
Main agents for acute episodes and to abolish recurrent episodes of Prinzmetal’s angina
Nitrates and calcium channel blockers(Nifedipine)
Types of necrosis seen in MI
Coagulation necrosis(preserved architecture, faded details)
Earliest detectable feature of myocyte necrosis
Sarcolemmal membrane disruption(which leads to leakage of cardiac enzymes into the circulation)
Time frame where gross changes in MI occur
12 hours after onset of symptoms
Color changes in MI
Mottling- 4 hrs
Bright yellow- 1 wk
Surrounding red granulation tissue- 2 wks
Gray-white scar- 2 months
Fibrinous pericarditis (bread and butter pericarditis) post-MI
Dressler syndrome
Sites of myorcadial rupture in MI
Free wall > IVS > Papillary muscle (decreasing order of frequency)
Preferred biochemical markers for MI
Cardiac-specific Troponin T and Troponin I
Preferred biochemical markers for re-infarction
CK-MB
Level of coronary artery stenosis sufficient to produce ischemia
70%(critical stenosis)
Primary cause of out-of-hospital deaths from STEMI
Ventricular fibrillation
Primary cause of in-of-hospital deaths from STEMI
Pump failure
Greatest delay usually occurs between
Onset of pain & patient’s decision to call for help
Principal goal of fibrinolysis
Prompt restoration of full coronary arterial patency
Extent of LV involvement that usually results in cardiogenic shock
Infarction >40%
Most common complication of angioplasty
Restenosis
Most common thrombi found in NSTEMI(composed mainly of platelets)
White thrombi
Most common thrombi found in STEMI(composed of cells and fibrin)
Red thrombi
Most common cause of sudden cardiac death
Coronary artery disease
Most common arrhythmia post-MI
Premature ventricular contraction(PVC)
Most common lethal arrhythmia post MI
Ventricular fibrillation
