Chapter 12 PowerPoint Flashcards
What is the most common cause of ischemic heart disease?
Atherosclerosis
What is atherosclerosis?
Plaque build up within coronary blood vessels causing a decrease in blood flow
Resulting in decrease O2
Reduction in CO2 and waste removal
What are the risk factors for atherosclerosis?
BAD HEART
BMI ≥ 30 (obesity; modifiable risk factor)
Age ≥ 65 (non-modifiable risk factor)
Diabetes Mellitus
Hypertension (most common risk factor)
EtOH (alcohol abuse)
An increase in LDL and a decrease in HDL (hyperlipidemia)
Relatives with CAD o e.g. relatives who passed away due to heart attack/MI
Tobacco use or Smoking increases endothelial injury and plaque formation
What are the 4 categories for ischemic heart disease?
Stable angina
Unstable angina
Subendocardial Infarct/NSTEMI
Transmural Infarct/STEMI
What is stable angina?
Stable plaque, Occlusion of 70%+
Chest pain with Exertion, resolves with rest
Subendocardial ischemia
What is unstable angina?
Unstable plaque, occlusion of 90%+
Chest pain at rest or worse with exertion
Subendocardial ischemia
What is subendocardial infarct?
Subendocardial Infarct/NSTEMI
Unstable Plaque, Thrombus formation
90%+ occlusion
Chest pain at rest and worse with exertion
Blood flow has been reduces for >30min
Irreversible damage (Death to tissue)
What is transmural infarct?
Transmural Infarct/STEMI
Unstable plaque, Thrombus formation
100% occlusion
Chest pain at rest, severe with exertion
Complete O2 loss
Entire myocardium from Endocardium to epicardial tissue infarct
What is acute coronary syndrome?
Acute Coronary Syndrome
A general term which encompasses:
Unstable angina
Subendocardial infarction / NSTEMI
Transmural infarct / STEMI
Symptoms for Ischemia or Infarction?
Nausea, Vomiting, Sweating Syncope, Sense of Impending Doom.
What does the onset in a time sense of ischemia or infarction look like?
Onset
<10 min Stable Angina
> Unstable Angina, NSTEMI, STEMI
Describe general facts/questions/diagnosis of ischemia or infaraction?
Onset
<10 min Stable Angina
> Unstable Angina, NSTEMI, STEMI
Provocation
What makes it Better or worse? Exertion?
Improve with rest or Nitro
Quality
Squeezing/stabbing/pressure chest pain
“Elephant on chest”
Radiation
Left Arm, Left Neck, Left Jaw
Epigastric Pain (Inferior STEMI)
Severity
Variable
Time
Constant
Atypical presentation (Silent)
Diabetics
Neuropathic
Elderly
Post Heart Transplant
No Chest pain
What will ischemia/infarct look like in the anterior portion (leads and artery affected)?
Left anterior descending artery
V1-V4
What will ischemia/infarct look like in the lateral portion (leads and artery affected)?
Left circumflex artery
I, aVL, V5, V6
What will ischemia/infarct look like in the inferior portion (leads and artery affected)?
Right coronary artery
II, III, aVF
