First Aid 291-295 Cardio Flashcards
what are xanthomas?
plaques or nodules composed of lipid laden histiocytes in skin
hypercholesterolemia can manifest what eye pathology earlier than the general population?
Corneal arcus?
which form of arteriosclerosis affects medium sized arteries?
Monckeberg - medial calcific sclerosis
Pipestem appearence of an a. on an CXR is a sign of what?
Monckeberg - medial calcific sclerosis
onion skinning of an artery is a proliferation of what cell type/which arteries?
smooth musc cells of small arteries and arterioles
Essential hypertension or DB lead to what pathology of arteries?
small arteries and arterioles - hyaline arteriolosclerosis
Why is there no obstruction of blood flow with Monckeberg arteriolosclerosis?
Affects tunica media, not intima, so lumen diam not affected
Which two growth factors are assoc with atherosclerosis?
PDGF & FGF
Complications of atherosclerosis?
Aneuryms, ischemia, infacts, PVD, thrombus, emboli
Most common locations of atherosclerosis in order?
Ab aorta > Coronaries > Popliteal a > carotid a
Symptoms of aortic aneurysm?
abdominal / back pain
Syphilis associated with what type of cardiac pathology? Which stage of syphilis?
Thoracic aortic aneurysm, tertiary syphilis
Which sexual genetic disorder could potentially lead to thoracic aortic aneurysm?
Turner’s (45, XO) bc of association with bicuspid aortic aneurysm
Cystic medial degeneration associated with which cardiac pathology?
Thoracic aortic aneurysm
Tobacco, cocaine, and triptans are associated with triggering which cardiac pathology?
Prinzmetal angina
Mediastinal widening on CXR is a sign of ?
aortic dissection
Aortic dissection affects which layer of artery?
tunica intima
Markedly unequal BP in arms is associated with which cardiac pathology?
Aortic dissection
Difference between Stanford A and Stanford B type Aortic dissection?
Stanford A - more proximal, asc aorta –> aortic arch
Tx/surgery
Stanford B - more distal, aortic arch –> desc aorta
Tx/BB, VD
What differentiates unstable angina vs NSTEMI?
No rise in cardiac biomarker elevation
What is Coronary steal syndrome?
Giving vasodilators in a patient with coronary stenosis will cause the dilation of normal vessels and reduces the flow to area distal to the stenosis. This is the principal behind cardiac stress test.
ECG signs of transmural vs subdendocardial MI?
transmural - ST elevation (STEMI), Q waves
subendocardial - NSTEMI = ST depressions
1 cause of sudden cardiac death?
lethal arrhythmia (VTACH, VFIB)
Diseases associated with sudden cardiac death
CAD, cardiomyopathy, heriditary ion channelopathies (long QT syndrome, Brugada syndrome)
wavy fibers appear how soon after an MI?
4-24 hrs
Biggest complication 1-3d post MI?
Postinfarction fibrinous pericarditis
If one sees macrophages and mariginal granulation tissue, how many days post MI?
3-14d
Major complications 3-14 days post MI?
free wall rupture –> tamponade
papillary muscle rupture –> mitral regurge,
IV septum rupture
LV pseudoaneurysm
Most likely complication in the first 24hrs after an MI?
Arrythmia, HF, Cardiogenic shock
What changes are seen in heart tissue in the first 4 hours post MI?
none
First cardiac biomarker to rise post MI?
myoglobin
Most specific cardiac biomarker post MI?
Cardiac troponin I
Which cardiac biomarker is useful to determine if there was a re-infaction?
CK-MB, normally falls after 48hrs, so if high after that, sign of re-infarction
Most common cause of death post MI?
Arrythmia
V1 - V2 leads MI = which area of heart? artery?
anterior, over the septum - LAD
V3- V4 leads MI = which area of heart? artery?
anterior side to the apex - distal LAD
V5 - V6 leads MI = which area of heart? artery?
anterior side to lateral heart - LAD or L circumflex
Leads I, aVL = which area of heart? artery?
lateral side - L circumflex
Leads II, III, avF = area of heart? artery?
inferior heart - R circumflex
What is Dressler syndrome?
Autoimmune, leads to fibrinous pericarditis
When would a postinfarction fibrinous pericarditis occur post MI?
1-3 d post MI
Which two complications of an MI can occur up to 14 days post MI?
Ventric free wall rupture, ventricular pseudoaneurysm formation (contained free wall rupture)
Which complication can appear 2 weeks to months post MI?
True ventricular aneurysm
When is the greatest risk for VSD post MI?
3-14 days post MI
