heart Flashcards
vast majority of Cardio disease
atherosclerosis
what is hallmark of atherosclerosis?
endothelial injury
is injury–>ischemia reversible or irreversible?
reversible
types of ischemia
tolerable, critical, lethal
symptoms of coronary stenosis
angina pectoris, asymptomatic, arrhythmia, sudden death, myocardial infarction, congestive heart failure
two types of angina pectoris?
unstable and stable
pain of ischemia relieved by:
rest, nitroglycerine (vasodilator)
complications of CAD:
MI, sclerosis, thrombosis, aneurysm
what is aneurysm?
weakening of wall causes dilation and rupture
clinical diagnosis of MI
cardiac biomarkers, ECG, cardiac catheterization, post mortem
clinical symptoms of MI
choking/pressure (left side), pass out, sweat, shock, weak pulse
most common cause of death from acute MI
ventricular fibrillation (arrhythmia) –>v-fib arrest
complications of MI
sudden death (25% of cases), heart failure, arrhythmia, cardiogenic shock, multisystem organ failure, weakening of arterial wal, aneurysm, valvular regurgitation
80% MI result from:
thrombus obstructed narrowed artery
what is artery of sudden death?
Left anterior descending
lateral infarction starts in:
left circumflex artery
the widow maker
anterior infarction
posterior infarction
right coronary artery obstruction
how diagnose MI?
consider med history, clinical presentation, 12 lead ECG, biomarkers (troponin)
myoglobin has molecular weight of:
16000 daltons
biomarkers of MI?
troponin, myoglobin, creatine kinase
what is creatine kinase?
dimer with wt of 86000 daltons
what kinds of dimer for CK in heart?
MM and MB
complications of myocardial infarction
mural thrombus, ventricular aneurysm, myocardial rupture, cardiac tamponade (pericardial effusion)
treatment?
clot busting drugs, percutaneous coronary intervention, CABG
what is CABG?
coronary artery bypass graft
what is pericardial effusion?
leakage of blood into pericardial space
what is PCI?
percutaneous coronary intervention; balloon tipped catheter system (^ lumen diameter, restore BF)
examples of clot busting drugs?
tPA, urokinase, streptokinase
CABG involve ___vein, __ artery
saphenous; internal mammary
what is congestive heart failure?
can’t pump all blood out of heart, back pressure to all organs behind failed chamber
left heart failure cause ___ congestion
pulmonary
right heart failure cause ___ congestion
peripheral
heart failure cause ___ which results in dyspnoea
edema
what is dyspnoea?
shortness of breath on exertion, constant, nocturnal
people who operate cardio-pulmonary bypass machine
perfusionist
what is RHD?
rheumatic heart disease related to strep infections
RHD caused by:
antibodies to strep cross-react with cardiac antigens
what is endocarditis?
inflammation of valves on left side of heart
what are vegetations?
deposition of inflammatory cells, fibrin, and platelets
what causes valve deformation?
healing by fibrous scarring
valve insufficiency causes:
regurgitation (ventricles become dilated or hypertrophic)
reflux of blood from ventricle to atrium during systole
mitral valve regurgitation
causes back flow of blood into left ventricle during diastole
aortic regurgitation
valve stenosis results in:
stagnation of blood into LA–>hypertension–>LV hypertophy
non modifiable risk factors for CAD
^ age, male, heredity
modifiable risk factors for CAD
hyperlipidemia, hypertension, physical inactive, smoke, obese, stress, diabetes
