Cardiovascular

Question 1

What is the pathogenesis of ischemic heart disease>

Answer 1

Supply < demand

Question 2

What level of occlusion is present in unstable angina?

Answer 2

No occlusion

Question 3

Characteristics of stable angina

Answer 3

Fixed stenosis
Typical predictable pattern
Occurs under stress (exercise, cold, emotion)
Typically 1-15 minutes
Goes away with rest and/or NTG
May continue without much change for years

Question 4

Cause of unstable angina

Answer 4

Transient formation and dissolution of thrombus
Blood flow to heart suddenly slowed by narrowed vessels or thrombus

Question 5

Characteristics of unstable angina

Answer 5

does not go away with rest or nitroglycerin

Question 6

What is considered ACS?

Answer 6

Unstable angina and myocardial infarction

Question 7

What are the stages of impairment after occlusion of a coronary artery

Answer 7

Ischemia: occurs as soon as decrease of blood supply, cardiac cells tolerate mild-moderate anoxia, returns to normal with reoxygenation
Injury: if ischemia severe or prolonged, reversible, cells return to normal or near normal after return of blood flow
Infarct: complete absence of blood supply, irreversible injury and death

Question 8

What area of the heart does a NSTEMi impact typically?

Answer 8

subendocardial wall

Question 9

what is present on EKG of NSTEMI

Answer 9

ST depression or T-wave inversion

Question 10

What part of the heart does a STEMI impact?

Answer 10

transmural

Question 11

EKG changes in STEMI

Answer 11

ST elevation turns into Q waves

Question 12

Type 1 MI classification

Answer 12

spontaneous MI due to primary coronary event such as plaque erosion and/or rupture, fissuring, or dissection

Question 13

Type 2 MI classification

Answer 13

Secondary to ischemia due to either increased oxygen demand or decreased supply

Question 14

Type 3 MI classification

Answer 14

Sudden unexpected cardiac death

Question 15

Type 4 MI classification

Answer 15

MI associated with coronary angioplasty or stents
4a: associated with PCI
4b: associated with stent thrombosis

Question 16

Type 5 MI classification

Answer 16

MI associated with CABG

Question 17

What is silent ischemia?

Answer 17

Ischemia without discomfort or pain
More common in diabetics, elderly, or women

Question 18

What is myocardial stunning?

Answer 18

Reversible myocardial dysfunction following reperfusion of ischemic insult
Contractile function returns to normal following early reperfusion

Question 19

What is hibernating myocardium

Answer 19

Prolonged reduction in blood flow causes ventricular contractile dysfunction
Improves once blood flow improves

Question 20

What area of the myocardium does the right coronary artery go to?

Answer 20

Inferior wall of LV
Right ventricle

Question 21

What area of the myocardium does the posterior descending artery go to?

Answer 21

Posterior wall

Question 22

What area of the myocardium does the left anterior descending artery lead to?

Answer 22

Septal wall
Anterior wall of LV

Question 23

What is the significance of a anterior wall MI?

Answer 23

Anterior wall performs main pump function –> decreased BP, increased HR, shock, and HF

Question 24

Definition of angina pectoris

Answer 24

chest discomfort typically due to atherosclerosis