Cardiopatía Isquémica Flashcards

1
Q

CARACTERISTICAS

A

1 CAUSA DE INSUFICIENCIA CARDIACA
DISBALANCE ENTRE OFERTA Y DEMANDA DE O2
1 ISQUEMIA - 2 LESION- 3 NECROSIS

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2
Q

CAUSA + FRECUENTE, PRINCIPAL CAUSA DE CARDIOPATIA ISQUEMICA

A

ATEROESCLEROSIS

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3
Q

Q ES LA ATEROESCLEROSIS

A

INFLAMACION CRONICA DE LAS ARTERIAS (MEDIANAS Y GRANDES)

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4
Q

ORDEN DE AFECTACION

A
  1. DESCENDENTE ANTERIOR (R. CORONARIA IZQ)
  2. CIRCUNFLEJA (R. CORONARIA IZQ)
  3. DESCENDENTE POSTERIOR (R. CORONARIA DERECHA)
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5
Q

FISIOPATO 1

A

LDL ++ (TRANSPORTAN COLESTEROL DEL HIGADO A TEJIDOS) - DEPOSITAN EN EL SUBENDOTELIO - SE OXIDA -++ INFLAMATORIO - VIENEN MONOCITOS - TRANSFORMAN EN MACROFAGOS

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6
Q

FISIOPATO 2

A

MACROFAGOS FAGOCITA EL LDL OXIDADO = CELULA ESPUMOSA

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7
Q

GRUPO DE CELULAS ESPUMOSAS

A

ESTRIA GRASA (1ERA LESION EN VASOS)

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8
Q

FISIOPATO 3

A

MACROFAGO NO SE DA ABASTO Y LDL SE ACUMULA EXTRACELULAR - ++CENTRO LIPIDICO -++ INFLAMACION -++ GROSOR DE ATEROMA

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9
Q

AHA CLASIFICACION DE LESIONES

A

ESTADIO I: LESION INICIAL - CEL. ESPUMOSAS
ESTADIO II: 1ERA LESION - ESTRIA GRASA
ESTADIO III: LESION INTERMEDIA - CENTRO LIPIDICO
ESTADIO IV :DEPOSITO DE COLESTEROL EXTRACELULAR - CENTRO LIPIDICO- PLACA DE ATEROMA

ESTADIO V: CAPA FIBROSA ALREDEDOR DEL CENTRO LIPIDICO COMPUESTA DE MUSCULO LISO Y FIBRAS DE COLAGENO “CAPA FIBROATEROMATOSA”
OBSTRUCCION PROGRESIVA - DISMINUYE FLUJO - CARDIOPATIA ISQUEMICA CRONICA - ANGINA ESTABLE (A)

ESTADIO VI: ROTURA DE PLACA “ACCIDENTE DE PLACA”
SE ROMPE PLACA FIBROSA (EXPONE COLAGENO) SE ACTIVA LA HEMOSTASIA - TROMBO- PRODUCIENDO OBSTRUCCION AGUDA “SICA”

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10
Q

TIPOS DE PLACA

A

PLACA ESTABLE Y PLACA VULNERABLE

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11
Q

PLACA ESTABLE

A
CENTRO LIPIDICO PEQUEÑO
GRUESA CAPA FIBROSA
DIFICIL Q SE ROMPA
OBSTRUCCION FIJA Y PROGRESIVA
CUADRO ISQUEMICO CRONICO 
ANGINA ESTABLE
PLACA NO TROMBOTICA
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12
Q

PLACA VULNERABLE

A
CENTRO LIPIDICO GRANDE
DELGADA CAPA FIBROSA
INFILTRADO LINFOCITARIO
FACIL DE ROMPERSE
ROMPE= TROMBO 
OCLUYE LA LUZ = SICA
PLACA TROMBOTICA
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13
Q

RESUMEN

A

PLACA DE ATEROMA = AÑOS
2 TIPOS DE PLACA = ESTABLE/ VULNERABLE
TROMBO SE ROMPE= OBSTRUCCION PARCIAL/ TOTAL
PARCIAL= PLAQUETAS = ANGINA INESTABLE /INFARTO NO Q
TOTAL= FIBRINA/ ONDA Q

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14
Q

ZONA MAS SENSIBLE A LA HIPOXIA/ NECROSIS

A

SUBENDOCARDIO (ZONA + ALEJADA DE LAS ARTERIAS CORONARIAS)

NECROSIS COAGULATIVA : SUBENDOCARDIO

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15
Q

ANGINA INESTABLE

A
  1. ISQUEMIA
  2. NECROSIS COAGULATIVA (SUBENDOCARDICO 1ERA “INFARTO NO Q”)
    ANGINA INESTABLE O INFARTO NO Q= TROMBO OCLUSION PARCIAL
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16
Q

FORMA GRAVE DE INFARTO

A

TRANSMURAL = NECROSIS DE TODA LA PARED
“INFARTO Q”
OCLUSION TODA LA LUZ

17
Q

FACTORES DE RIESGO

A

PCTE AÑOSO >50a
VARON
ANTECEDENTE FAMILIAR

18
Q

FX RX CARDIOVASCULARES MAYORES

A

DB
HTA
DISLIPIDEMIA
TABACO