coronary atherosclerosis & MI Flashcards
wat is the response to injury model for ASCVD?
- endothelial injury
- monocytes attach to endothelial cell
- growth factors released
- platelets may participate
- complex lesions evolve over years
what is the Intimal collection of MACROPHAGES AND LIPID LADEN SMC’s?
fatty streak
what is the advanced lesion?
fibrous plaque
what is the MOST COMMON CAUSE OF DEATH IN DIABETIC PATIENTS
atherosclerosis
what is unstable angina
new onset, subjectively worse discomfort, onset with less activity, angina at rest
typically lasts LESS THAN 30 MINS, onset gradual, worsened by work & lying down
angina
stress testing is used to dx
atypical chest discomfort
when is stress testing not indicated?
asympt men or women
ST depression >2 on stress test is a certain dx of?
Myocardial ischemia
do beta blockers have any effect on O2 supply?
no, just reduce myocardial oxygen demand
what is a stable angina pectoris?
same pattern each time
stress testing can be used for prognosis of?
stable angina, post-MI, post-revascularization
what drugs can be used for pharmacological stress testing?
adenosine, dipyramidole, dobutamine
what tx for MI decrease pre-load, coronary dilation, enhance endothelial activity
nitrates
what tx for MI decrease HR and contractility
beta blockers
what tx for MI prevent spasms, reduction of afterload, some reduce contractility, DECREASE AFTERLOAD
CCB
factors affecting supply of myocardium
- vascular resistance
- coronary blood flow
- O2 carrying capacity
factors affecting demand of myocardium
- HR
- contractility
- systolic wall tension
when stress test is combined with ____, it increases the predictive power
imaging (echo or nuclear)
