Coronary Heart Diesase and Thromboembolic CV pathologies Flashcards
1
Q
Oxygen supply to myocardium
A
- Hearts myocardium receives high levels of oxygen during diastole as blood is entering heart
- When there is no contraction heart receives high amount of blood supply
2
Q
Coronary circulation
A
- Two tiny arteries leaving out of the aorta
- Profuse blood to the myocardium
- Handles high BP
3
Q
Myocardial ischemia
A
- Thickening of internal surfaces of arteries or progression of atherosclerosis lesions occlude oxygen supply cause CVD
4
Q
Coronary artery flow angina
A
- Atherosclerosis lesions narrow coronary artery and reduce ability for dilation
- Lesions rupture and stimulate platelet aggregation causing thrombus to occlude artery restrict blood supply
5
Q
Symptoms of angina
A
- Reduced capacity in artery causes stress chest pains no change in troponin ECG
6
Q
Unstable angina
A
- Rapid reduction of blood flow due to rupture severe chest pain requiring urgent treatment
- No change in troponin some ST depression in ECG
7
Q
Antianginal drugs
A
- Nitrates for acute attacks/ preventative measures - sublingual glyceryl trinitite
8
Q
Nitric acid cytoplasmic guanylyl cyclase receptor
A
- Nitric oxide endothelium derived vasodilator factor
- Stimulate cytoplasmic guanylyl cyclase
- Activate protein kinase G causing smooth muscle dilation
- PDE isoform breaks down cGMP
9
Q
Nitrates
A
- Acute angina attacks/ Preventative measure
- Isosorbide dinitrate (organic)
- Isosorbide mononitrate (organic)
- nitroglycerin
10
Q
The effects of nitrates on Systemic vasculature
A
- Increased venous dilation
- decrease venous pressure
- Decrease arterial pressure
11
Q
The effects of nitrates on cardiac
A
- Reduced preload and afterload
- Decrease oxygen demand
12
Q
The effects of nitrates on coronary
A
- Prevents reverse vasospasm
- Vasodilation
- Improves subendocardial perfusion
- Increased oxygen delivery
13
Q
Beta-Blockers
A
- Cardio specific depression of sympathetic activity
- Reduce heart rate & lengthened diastole
- Increased oxygen supply to myocardium
- Patient with variant angina or HF are contraindicated
14
Q
Calcium- Channel blocker
A
- Verapamil and diltiazem cardiac specific
- Amlodipine effective for patient with Prinzmetal angina
15
Q
Second line inhibitors
A
- Ivabradine selectively block hyperpolarization activated cyclic nucleotide gate in SA node
- Lowers heart rate without effecting contractility of cardiac muscle
16
Q
Class ID sodium channel blocker
A
- Ranolazine blocks late inward sodium currents occurring during phase II of ventricular action potentials
17
Q
Potassium channel activator
A
- Nicorandil activate ATP sensitive K+ channels to enhance K+ efflux and hyperpolarization of vascular smooth muscle
- Decrease calcium ion entry reduce cardiac contraction
18
Q
Progressive CVD
A
- Narrowing transient occlusion or microembolization of thrombus
19
Q
Non-ST segment elevation MI
A
- Myocardial ischemia and necrosis changes in troponin and no change in ECG
20
Q
Extreme CVD
A
- Complete and prolonged exclusion of epicardial coronary blood vessel
21
Q
ST Segment elevation MI extreme
A
- Dysfunction and death of cardiac myocytes
- Troponin levels increase and elevation of ST levels and ECG
22
Q
Thrombosis
A
- Blood clotting in artery
23
Q
Embolism
A
- Blood clot materials moving in the blood vessel obstruct flow
24
Q
Cardiovascular atherosclerosis
A
- Fat deposit and aggregation of thrombus ruptures and reaches small arteries causing ischemia
25
Q
Risk factors that lead to thrombus formation
A
- Endothelial dysfunction - Smoking and hypertension
- Hypercoagulability - Hereditary - Factor V Leiden, Protein C and S deficiency, Cancer
Stasis - immobility polycythemia
26
Q
Artery
A
- Thrombocytes (Platelets)
- Contain no nucleus/ mitochondria and blood clotting
27
Q
Haemostasias - Vascular spasm
A
- Rupture in Artery
- Vascular spasm occurs prevent blood loss
- Create signal for clotting factors chemicals and mediators released at sight of injury
- Damage to collogen, endothelial cells and vascular smooth muscle cells
28
Q
Platelet activation plug
A
- Platelet stick to exposed collogen
- Platelets stimulate ADP, Thromboxane A2 and serotonin
- Van-Wilbur factor stabilizes collogen and platelet adhesion
29
Q
Coagulation patch
A
- Clotting factors in the liver, vitamin K and the biosynthesis of I to XIII
- Prothrombin Activator to Prothrombin to Thrombin to fibrinogen to fibrin insoluble to fibrin mesh
30
Q
Platelet endothelial interaction
A
- thrombin activate platelet by PAR
- Platelets stick on exposed collogen
- Protease activated receptor is mediated by the thrombin for platelets to interact with cell surface
30
Q
Clot regulation in a healthy individual
A
- Endothelial cells in plasma membrane release heparin
- Work as anticoagulant recruit antithrombin in circulation AT-III binding negatively inhibits thrombin activation on platelet
- Clot formation prevented
31
Q
Atherosclerosis
A
- Thrombin mediated platelet activation become abrupt and accelerated due to endothelial dysfunction and damage
31
Q
Platelet endothelial interaction (ADP - mediated process)
A
- Activated platelets stimulates release of ADP which acts on P2Y 12 receptors activate positive feedback change platelet to start shape
32
Q
Negative feedback of ADP during Haemostasias
A
- ADP binds P2Y1 receptor stimulates the release of prostacyclin and nitric oxide from endothelial cells to prevent plug formation
33
Q
Atherosclerosis
A
- ADP meditated platelet formation become accelerated due to endothelial dysfunction damage
- Smoking and hyperlipidemia damage endothelial and challenge negative feedback more clot
34
Q
Platelet fibrin plug formation
A
- Von-Wilber factor bridge between collogen exposed in damaged blood vessels & glycoprotein receptor GPIIb expressed in activated platelets
- GPIIb receptor binds fibrinogen and form platelet fibrin plug
35
Q
Clot and vessel healing
A
- Clot retraction occurs actin and myosin in platelet contract pulls fibrin
35
Q
Platelet derived growth factor
A
Stimulate smooth muscle and fibroblast division
36
Q
Vascular endothelial growth factor
A
- Rebuilds endothelial lining by multiplying endothelial cells
37
Q
Fibrinolysis
A
- Plasminogen plasma protein trapped in clot converted and plasmin digest fibrin
