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Systems 1 > CV 7 IHD > Flashcards

CV 7 IHD Flashcards

1
Q

ECG is a – method of evaluating the electrical activities of the heart

A

direct

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2
Q

standard ECG provides a –

A

60 sec recording

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3
Q

Abnormalities in cardiac cycle present as – in ECG

A

changes in length and amplitude of electrical waves

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4
Q

different leads provide different views of –

A

same electrical event

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5
Q

incidence of IHD

A

7 million people

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6
Q

incidence of MI

A

1.5 million people

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7
Q

myocardial oxygen demand in excess of supply

A

ischemia

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8
Q

continued ischemia leading to muscle damage

A

infarction

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9
Q

coronary arteries and capillaries usually have – resistance unless occluded

A

low

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10
Q

sense mechanical forces and regulates vascular tone

A

endothelium

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11
Q

protective cholesterol

A

HDL

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12
Q

best predictor of atherosclerotic heart disease

A

total cholesterol to HDL ratio (ideal is 3.5 and lower)

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13
Q

– has antifibrinolytic properties and an increase in – correlates with heart disease

A

lipoprotein

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14
Q

homocysteine (sulfur) excess has direct toxic effect on – interfering with clotting factors and promotion of LDL

A

endothelial cells

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15
Q

what can correct homocysteine excess?

A

folic acid

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16
Q

what is a marker of systemic inflammation?

A

C-reactive protein

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17
Q

Strongly correlated with risk of MI, stroke, peripheral arterial disease, and sudden cardiac death

A

C-reactive protein

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18
Q

what is emerging as an important risk factor

A

inflammation

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19
Q

Atheroma evolution: innate and adaptive inflammation in atherogenesis

A

foam cells release proinflammatory cytokines

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20
Q

Atheroma evolution: smooth muscle cells

A

migration and proliferation –> cell death

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21
Q

Atheroma evolution: arterial ECM

A

collagen deposits –> outward growth of intima

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22
Q

Atheroma evolution: angiogensis

A

plaque neovessels

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23
Q

chronic atherosclerosis

A

arterial stenosis, gradual occlusion and limited flow

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24
Q

acute atherosclerosis

A

disrupted plaque, rupture, and thrombosis

25
Q

example of chronic disease

A

stable angina

26
Q

example of acute disease

A

acute coronary syndrome

27
Q

pain of cardiac ischemia

A

pressure, squeezing, burning

28
Q

pain may radiate to –

A

left shoulder, jaw and arm (lower back for women)

29
Q

no symptoms present, occurs commonly and mortality as high as with pain

A

silent ischemia

30
Q

duration of stable angina

A

2-10 min

31
Q

duration of unstable angina

A

< 20 min

32
Q

duration of MI

A

> 30 min

33
Q

nausea, vomit, cold sweat, SOB is associated with –

A

acute ischemia

34
Q

heart sounds for cardiac ischemia

A

distant, gallop rhythms, occasional murmurs

35
Q

cardiac ischemia’s effect on lungs

A

rales

36
Q

what is the most important element of diagnostic work up of acute vs chronic ischemia?

A

history

37
Q

evidence of MI on EKG

A

abnormal ST and T wave

38
Q

Limitations of EKG: when combined with – for ischemia work up, sensitivity is only about 65% while specificity is 90%

A

exercise

39
Q

when diagnosing an infarction –

A

changes in heart may take days to dev

40
Q

myocardial perfusion diminishes with ischemia

A

nuclear cardiology

41
Q

abnormal wall motion from ischemia or infarction

A

echocardiogram

42
Q

demonstrates vessel obstruction

A

coronary angiography

43
Q

most commonly used nuclear cardiology test

A

SPECT scan

44
Q

SPECT scan: radioactive tracers are – and images are obtained with heart at rest or after exercise

A

injected IV

45
Q

because radioisotope concentration in myocardium depends on perfusion rate, SPECT scan shows –

A

ischemia

46
Q

the-99

A

emits high photon (short 1/2 life)

47
Q

tha-201

A

emits low photon (long 1/2 life)

48
Q

shows presence of absence of perfusion and quantitative measurement of myocardial perfusion and metabolism

A

PET scan

49
Q

PET scan uses isotope tracers tagged to a glucose analog and have very –

A

short 1/2 lives

50
Q

what is the gold std

A

coronary angiography

51
Q

blood tests are useful tests for –

A

infarction

52
Q

useful screening for silent ischemia?

A

ambulatory EKG

53
Q

angioplasty usually takes –

A

1 day

54
Q

coronary artery bypass graft surgery or CABG takes –

A

a couple of days (open heart surgery)

55
Q

ischemia can lead to –

A

contractile dysfunction
arrhythmia
infarction

56
Q

blood test showing – is a sign of infarction

A

cardiac troponin and creatine kinase MB isoenzyme

57
Q

send balloon catheter to stretch coronary vessel

A

coronary angioplasty

58
Q

do NOT use AB prophylaxis after 6 months of bypass surgery because –

A

stint may embolize –> another MI

Systems 1 (22 decks)

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