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Human Disease: Exam 2 > Chapter 11: Myocardial Infarction > Flashcards

Chapter 11: Myocardial Infarction Flashcards

1
Q

A cessation of normal cardiac contractions

A

Cardiac arrest (asystole)

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2
Q

What is the most common cause of cardiac arrest?

A

V fib

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3
Q

An actual necrosis of the heart muscle starved of blood/oxygen

A

Myocardial infarction

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4
Q

What is the most sever consequence of CAD/CHD?

A

MI

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5
Q

Full-thickness infarct from
endocardium to epicardium, usually from clot in major
coronary artery

A

Transmural infarct

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6
Q

MI in which only part of wall undergoes necrosis

A

Subendocardial infarct

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7
Q

Which muscles of the heart are typically involved in an MI?

A

Muscles of the L ventrical and septum (because they are thicker and require larger blood supply, have greater O2 requirements)

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8
Q

Infarcts of the left anterior wall caused by L descending artery blockage are called what?

A

Widow-maker infarct

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9
Q

What are the 4 basic mechanisms that trigger a heart attack (MI or cardiac arrest)?

A

1) Sudden blockage
2) Hemorrhage
3) Arterial spasm
4) Sudden greatly increased myocardial oxygen requirements.

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10
Q

True or false: MI patients usually develop one or more complications.

A

True

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11
Q

What is the 5 year survival rate following an MI?

A

80%

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12
Q

What are the 3 major causes of death following an MI?

A
  1. Fatal arrhythmia
  2. Heart failure
  3. Cardiac rupture with
    cardiac tamponade
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13
Q

What percentage of MI’s begin with angina? What percentage occur without warning?

A

50%; 50%

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14
Q

What is the most important blood enzyme test for MI dx?

A

Troponin T and troponin I

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15
Q

In what percentage of cases can you dx an MI accurately with an EKG and troponin test?

A

99%

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16
Q

How can angina pectoris be treated?

A

1) Rest

2) Vasodilator (e.g., nitroglycerin)

17
Q

What does temporary insufficient blood supply to the heart lead to?

A

Angina pectoris

18
Q

What does prolonged insufficient blood supply to the heart lead to?

A

MI

19
Q

True or false: Heart muscle damaged by an MI can regenerate functional tissue.

A

False; undergoes scar repair and becomes non-contractile.

20
Q

What are two causes of cardiac arrest?

A

1) asystole (less common)

2) Ventricular fibrillation

21
Q

In what two ways can a heart attack be manifested?

A

1) Cardiac arrest

2) MI

22
Q

What 4 basic mechanisms can lead to a heart attack?

A

1) Sudden CA blockage
2) Hemorrhage into an atheromatous plaque
3) Arterial spasm next to plaque in a CA
4) Sudden increase in myocardial oxygen need

23
Q

How do women’s MI symptoms differ from men?

A

Women are much less likely to have chest

pain, arm/jaw pain, nausea/vomiting, or strong anxiety.

24
Q

Inflammation of lining of the lungs and chest.

A

Pleurisy

25
Q

What are two conditions whose symptoms can mimic a a heart attack

A

1) Heartburn/indigestion
2) Pleurisy
3) Gall bladder attack
3) Muscle strain

26
Q

Partial necrosis caused by an MI

A

subendocardial necrosis

27
Q

Necrosis through all layers of the heart caused by an MI

A

transmural necrosis

28
Q

What two key test are able to accurately diagnose MI 99% of the time?

A

EKG and troponin levels

29
Q

What are the three groups for Acute Coronary Syndromes?

A

1) Severe unstable angina (ST depression, no rise in troponins or CK)
2) Minor myocardial damage (non-STEMI, elevated troponins and CK
3) Major myocardial damage (STEMI, elevated troponin and CK)

30
Q

How is severe unstable angina diagnosed? How is it treated?

A

1) ST depression, no rise in troponins or CK

2) Drugs

31
Q

How is minor myocardial damage (non-STEMI) diagnosed? How is it treated?

A

1) ST depression, increased troponin (not CK)

2) Angioplasty

32
Q

How is major Myocardial damage treated (STEMI)?

A

Total CA blockage; treated with angioplasty or thrombolytics ASAP.

33
Q

Within what time period must thrombolytics be given to given to prevent irrversible tissue infarction?

A

within 6 hours

34
Q

What is the very best treatment for an MI?

A

angioplasty (unblocks CA in 90% of patients)

35
Q

What device can be used to treat patients who are at high risk of v-fib?

A

implantable cardioverter defibrillator

36
Q

What implantable device senses v-fib and automatically shocks the heart?

A

cardioverter defibrillator

37
Q

What is the percentage of MIs that are survived if patients are hospitalized?

A

95%

38
Q

What percentage of MI deaths occur outside of the hospital?

A

1/3

Human Disease: Exam 2 (37 decks)

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