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CPR II > Cardio Pathology Part 1- Hillard > Flashcards

Cardio Pathology Part 1- Hillard Flashcards

1
Q

LAD infarction leads to death of which parts of the heart

A

Apex
LV anterior wall
anterior two thirds of septum

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2
Q

Left Circumflex infarction leads to death of which parts of the heart

A

LV lateral wall

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3
Q

RCA infarction leads to death of which parts of the heart

A

RV free wall
LV posterior wall
posterior third of septum

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4
Q

CAD is….

A

leading cause of death

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5
Q

Risk factors of atherosclerosis

A

increasing age, male gender, HTN, hyperlipidemia, cigarette smoking, diabetes

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6
Q

most sensitive AND specific biomarkers of myocardial damage

A

Troponin T and I (cTnT and cTnI)

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7
Q

time to elevation of CKMB, cTnT and cTnI

A

3-12 hours

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8
Q

time to normalization of CKMB

A

48-72 hours

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9
Q

time to normalization of cTnI and cTnT

A

> 5 days

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10
Q

transient occlusion leads to what type of infarct

A

regional subendocardial infarct

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11
Q

global hypotension (shock) leads to what type of infarct

A

circumferential subendocardial infarct

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12
Q

small intramural vessel occlusions (drug users) leads to what type of infarct

A

microinfarcts

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13
Q

coronary artery blood flow direction?

A

from the outside towards the myocardium then the endocardium

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14
Q

the area at most risk with CA occlusion

A

the innermost layer of the heart, myocardium, is first impacted.

The endocardium will still be viable although it is the most innermost layer.

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15
Q

30 min-4hr irreversible injury leads to

A

waviness of fibers at border

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16
Q

4-12hrs of irreversible injury leads to

A

early coagulation necrosis; edema

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17
Q

12-24hrs of irreversible injury leads to

A

ongoing coagulation necrosis; pyknosis of nuclei; myocyte hypereosiniophilia; contraction band necrosis

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18
Q

1-3 days of irreversible injury leads to

A

a yellow-tan infarct center (gross) and coagulation necross with loss of nuclei; infiltrate of neutrophils

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19
Q

3-7 days of irreversible injury leads to

A

a hyperemic border (gross) and disintegration of dead myofibers; early phagocytosis of dead cells by macrophages at infarct border

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20
Q

7-10 days of irreversible injury leads to

A

yellow-tan and soft depressed red-tan margins (gross) and well-developed phagocytosis and granulation tissue at margins

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21
Q

10-14 days of irreversible injury leads to

A

collage deposition

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22
Q

2-8 weeks of irreversible injury leads to

A

gray-white scar (gross) and increased collagen deposistion

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23
Q

> 2 months of irreversible injury leads to

A

dense collagenous scar

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24
Q

the early complications of a MI are

A

life threatening arrhthmyia and cardiac dysfunction (shock)

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25
Q

arrhythmias occur within

A

1 hour of onset of myocardial infaction

the fatal arrhythmia is (V fib)

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26
Q

cardiogenic shock depends on

A

size of infarct and associated loss of function which leads to cardiogenic shock

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27
Q

early complications (time frame)

A

within 24 hours

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28
Q

intermediate complications (time frame)

A

1-3 days

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29
Q

the intermediate complications of a MI are

A

Septal, Free Wall, Papillary muscle rupture; acute pericarditis (fibrinous, serofibrinous)

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30
Q

myocardial rupture typically requires a

A

transmural infarct 2-4 days post MI (typically fatal)

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31
Q

which muscle is the most common one to rupture

A

the papillary muscles

32
Q

what are the risk factors to myocardial rupture

A

increase in age, first MI, absence of LV hypertrophy

33
Q

rupture of free wall can lead to

A

blood accumulating in the pericardial space –> acute pericardial tamponade (the heart can’t fully relax during diastole and puts strain on the heart)

34
Q

ventricular septal rupture leads to

A

anterior infarctions

35
Q

papillary muscle rupture leads to

A

mitral regurgitation

36
Q

late complications of MI occur after

A

2 weeks

37
Q

3 main late complications of MI

A

chronic pericarditis (Dressler syndrome), ventricular aneurysm, life-threatening arrhthmyias, progressive congestive heart failure

38
Q

what is Dressler syndrome

A

a fibrinous pericarditis that is due to an immune response to myocardial proteins in blood. Pt will be FEBRILE.

39
Q

angina pectoris

A

recurrent chest pain induced by myocardial ischemia insufficient to induce myocardial infarction

40
Q

what causes the pain in angina pectoris

A

pain caused by adenosine and bradykinin release

41
Q

what is a stable angina

A

stenotic occlusion of coronary artery
relieved by rest OR vasodilators
induced by physical activity, stress

42
Q

what is a Prinzmetal variant angina

A

episodic coronary artery spasm, often occurs at rest
relieved with vasodilators
unrelated to physical activity, HR or BP
have recurrent episodes every 3 to 6 months and feel normal between those episodes

43
Q

what is an Unstable angina

A

present at REST
“Crescendo pattern” increasing in severity or duration
crescendo-type can be caused by progressive mechanical obstruction

44
Q

what test is used for stable angina

A

exercise stress test

45
Q

pathophysiology of unstable angina if the symptoms are acute chest pain with activity and rest

A

this is due to a ruptured plaque with non-occlusive thrombus

46
Q

pathophysiology of unstable angina if the symptoms are “crescendoing angina” that does not occur at rest

A

this is due to a progressive mechanical obstruction

47
Q

stable angina leads to

A

demand ischemia, no infarct

48
Q

unstable angina leads to

A

supply ischemia, no infarct

49
Q

NSTEMI leads to

A

subendocardial infarct

50
Q

STEMI leads to

A

transmural infarct

51
Q

traumatic heart injury

A

leads to pericardial tamponade due to blunt force

52
Q

weak point of the aorta is where it is tethered to the pulmonary artery which is….

A

the ligamentum arteriosum

53
Q

life-threatening hemorrhage and most common way people die due to car crash

A

tearing or shearing of the ligamentum arteriosum

54
Q

first common cause of death in MVA

A

head trauma

55
Q

second common cause of death in MVA

A

hemorrhage of aorta

56
Q

causes of arrhythmias

A

abnormalities in gap junctions

abnormalities of spacial relationships of myocytes

57
Q

cardiac causes of arrhythmias

A 
ischemic heart disease--> MOST important cause
cardiomyopathies
myocarditis
valvular disease
familial/congenital disorders
58
Q

what is Sick sinus syndrome

A

SA node damaged–> bradycardia

this happens bc the AV node now takes over and the AV node is slower than SA node

59
Q

Bradycardia defined as

A

less than 50-60 beats/min

60
Q

what is Atrial fibrillation?

A

myocytes depolarize independently and sporadically due to atrial dilation, with variable transmission in AV node

causes an irregular, irregular HR

can cause thrombus formation, risk of thromboembolism

61
Q

what is heart block

A

dysfunctional AV node

62
Q

first degree heart block

A

prolonged PR interval

63
Q

second degree heart block

A

intermittent transmission

64
Q

third degree heart block

A

complete failure

65
Q

increased length of ventricular depolarization to repolarization is called…

A

Long QT syndrome

66
Q

what is Long QT syndrome caused by

A

usually due to abnormal ion channels causing arrhythmogenic disease (hereditary channelopathies)

67
Q

what is Torsades des Pointes

A

It’s Long QT Syndrome that leads to syncope and sudden cardiac death

68
Q

conditions that cause dilated cardiomyopathy

A

excessive alcohol use
myocarditis
certain drugs
iron overload

69
Q

volume overload can cause

A

systolic dysfunction (heart can’t pump out enough blood)

70
Q

CHF may result from

A

loss of ability to fill the ventricles during diastole (diastolic dysfunction)
loss of myocardial contractile function (systolic dysfunction)

71
Q

most common side for CHF (right vs left)

A

left sided heart failure

72
Q

left sided heart failure (systolic failure) causes

A 
ischemic heart disease
htn
aortic stenosis
dilated cardiomyopathy
DECREASED ejection fraction
73
Q

left sided heart failure (diastolic failure) causes

A 
htn
aortic stenosis
hypertrophic cardiomyopathy
restrictive cardiomyopathy
NORMAL ejection fraction
74
Q

right sided heart failure causes

A

Cor pulmonale (lung disease/dysfunction)

75
Q

left sided heart failure main causes

A

ischemic heart disease
htn
left-sided valve disease

CPR II (3 decks)

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