CSIM1.63 CDVS D/z 3

Question 1

What is raynauds disease and what can it lead to?

Answer 1

Spasms in artery smooth muscle, can cause ischaemia.

Question 2

What are some high risk organs to ischaemia?

Answer 2

Brain and heart

Question 3

Difference between gradual and acute ischaemia?

Answer 3

Acute ischaemia is more harmful as the organ has not had time to build collaterals, leads to infarction quicker

Gradual ischaemia takes place over time, allowing the organ to develop collateral blood supplies to perfuse it.

Question 4

Examples of capillary ischaemia?

Answer 4

Frostbite
Cryoglobulinaemia
DIC
Diabetic microangiopathy of the eyes

Question 5

Whatis cryoglobulinaemia?

Answer 5

Certain proteins in the blood precipitate and solidy at lower temperatures, they become insoluble masses that can then cause occlusions and ischaemia

Question 6

What happens in a venous obstruction?

Answer 6

Causes back flow and eventually stops arterial inflow as well leading to infarction.

E.g. Strangulated gut hernia

Question 7

What is a transmural myocardial infarction?

Answer 7

An infarct in the heart that affects deep into the walls of the myocardium

Question 8

How does chronic cardiac failure arise?

Answer 8

An infarct that progressively becomes fibrotic and unable to function.

As more fibrosis occurs, heart function goes down which can lead to myocardial degeneration and myocyte atrophy.

Question 9

What can bring about angina?

Answer 9

Exertion linked to atheromas with luminal stenosis i.e. Lack of perfusion for a transient amount of time

Question 10

Describe 1. Stable angina, 2. Variable angina 3. Unstable/crescendo angina

Answer 10

Stable anginas occur due to exertion and resolve itself after a period of rest

Variable anginas occur at rest and are due to arterial spasms due to severe athermatoses

Unstable/crescendo anginas occur at rest and with progressive ease of onset and frequency, caused by disruption of plaque

Question 11

What are non-ST-elevated myocardial infarcts? (NSTEMI)

Answer 11

Unstable angina is a milder form of NSTEMI, no biomarkers of myocardial infarction

A more serious NSTEMI would involve elevated biomarkers of myocardial necrosis and a depression/inversion of the ST segment, usually do not have Q waves

Question 12

What’s the difference between NSTEMI and STEMI

Answer 12

STEMI involves prolonged and sustained occlusions. They have raised biomarkers of myocardial infarction and raised ST segment, they also usually have Q waves

Question 13

Two branches of the LCA? Where do they supply?

Answer 13

Left anterior descending artery -> anterior left V, anterior 2/3 interventricular septum

Left circumflex artery lateral wall of left V

Question 14

Where does the right coronary artery supply?

Answer 14

Posterior left ventricle

1/3 posterior interventricular septum

Question 15

Describe possible complications during early phase after an MI

Answer 15

Reinfarction

Arrhythmias

Acute cardiac failure

Acute pericaditis

Cardiac rupture -> haemopericardium

Question 16

How does a cardiac tamponade cause harm?

Answer 16

If the pericardium is filled with blood, it compresses the heart and prevents it from pumping, this can cause a cardiac arrest.

Question 17

What are some fatal site for a cardiac rupture?

Answer 17

Anterior wall of the heart (free wall)
Or interventricular septum
Or papillary muscle

Question 18

What are some chronic complications that can arise after an MI

Answer 18

Recurrent MIs

Aneurysm

Chronic cardiac failure

Dressler syndrome

Question 19

What is dressler syndrome?

Answer 19

Pericarditis occuring weeks to months after the MI caused by immunological response.