Cardiovascular Disease

Question 1

Atherosclerosis - characteristics

Answer 1

lipid laden plaques in moderate and large arteries

thickening and narrowing of intimal layer of blood vessel wall from accumulation

Question 2

Acute coronary syndrome (ACS) - Coronary artery disease - characteristics

Answer 2

involves spectrum of clinical entities

Imbalance of myocardial oxygen supply and demand

Question 3

Acute coronary syndrome (ACS) - Coronary artery disease - Angina pectoris

Answer 3

Chest pain or pressure due to ischemia

Can be accompanied by Levine’s sign (pt clench fist over sternum)

Question 4

Acute coronary syndrome (ACS) - Coronary artery disease - Angina pectoris - 3 types of angina

Answer 4

Stable
Unstable
Variant (Prinzmetal’s)

Question 5

Acute coronary syndrome (ACS) - Coronary artery disease - Angina pectoris - Stable angina

Answer 5

Classic exertional angina occurring during exercise or activity
Relieved with rest or nitroglycerin

Question 6

Acute coronary syndrome (ACS) - Coronary artery disease - Angina pectoris - Unstable angina

Answer 6

insufficiency at any time without precipitating factors

Question 7

Acute coronary syndrome (ACS) - Coronary artery disease - Angina pectoris - Variant (Prinzmetal)

Answer 7

Caused by vasospasm of coronary arteries in the absence of occlusive disease
responds well to nitro or Ca channel blocker

Question 8

Acute coronary syndrome (ACS) - Coronary artery disease - Myocardial infarction

Answer 8

Prolonged ischemia, injury, and death of an area of the myocardium caused by occlusion of one or more of the coronary arteries

Question 9

Acute coronary syndrome (ACS) - Coronary artery disease - MI - zones of infarction - Zone of infarction

Answer 9

consists of necrotic, noncontractile tissue, electrically inert, on ECG will see pathological Q wave

Question 10

Acute coronary syndrome (ACS) - Coronary artery disease - MI - zones - zone of injury

Answer 10

Area immediately adjacent to central zone
tissue is noncontractile, cells unstable
on ECG will see elevated ST

Question 11

Acute coronary syndrome (ACS) - Coronary artery disease - MI - zones - zone of ischemia

Answer 11

outer area, cells undergoing metabolic changes

on ECG see T wave inversion

Question 12

Acute coronary syndrome (ACS) - Coronary artery disease - MI - infarction sites - Transmural

Answer 12

full thickness of myocardium

Often a STEMI or Q wave MI

Question 13

Acute coronary syndrome (ACS) - Coronary artery disease - MI - infarction sites - Nontransmural

Answer 13

subenchocardial, subepicardial, intramural infarctions

NSTEMI or non Q wave MI

Question 14

Acute coronary syndrome (ACS) - Coronary artery disease - Heart failure

Answer 14

clinical syndrome where the heart is unable to maintain adequate circulation of blood to meet metabolic needs of body

Question 15

Acute coronary syndrome (ACS) - Coronary artery disease - heart failure - types - Left sided

Answer 15

AKA CHF

characterized by pulmonary congestion, low CO due to back up of blood from LV to LA and lungs

Question 16

Acute coronary syndrome (ACS) - Coronary artery disease - heart failure - types - right sided

Answer 16

characterized by increased pressure load on RV with higher pulmonary vascular pressures - mitral valve disease or chronic lung disease
Hallmark jugular vein distention

Question 17

Acute coronary syndrome (ACS) - Coronary artery disease - heart failure - types - biventricular failure

Answer 17

severe LV pathology producing back up into lungs increased PA pressure and RV signs of HF

Question 18

Acute coronary syndrome (ACS) - Coronary artery disease - heart failure - types - compensated heart failure

Answer 18

heart returns to functional status with reduced CO and exercise tolerance