Heart disease

Question 1

myocardial infarction

Answer 1

when blood flow is decreased or stop to part of the heart causing damage to the muscle. Occur to due to coronary heart disease. Muscle is unable to receive the O2 and nutrients it needs to respire and therefore dies causing the heart not to pump blood properly

Question 2

most cardiac markers are

Answer 2

enzymes

Question 3

cardiac biomarkers

Answer 3

-creatine kinase
-cardiac troponin T ned I
-myogloblin
Natriuteritc peptides

Question 4

creatine kinase

Answer 4

Creatine kinase
Myocardial muscle creatine kinase is found mainly in the heart
Levels increase within 3-12 hours of onset of chest pain and reach peak values at 24 hours
Not as sensitive or specific as troponin levels

Question 5

cardiac troponin T and I

Answer 5

Troponin is a protein released from myocytes when irreversible myocardial damage occurs- highly specific to cardiac tissue
Troponin level is dependent on infarct size- providing an indicator or prognosis
Use of sensitive assays- more patients with angina will be classified as having non ST elevation myocardial infarction.
May not be detectable for 6 hours after attack- most sensitive early marker is myoglobin

Question 6

why is cardiac troponin T and I the preferred marker for myocardial injury

Answer 6

highest snesiitvites and spceiificities for diagnosis of acute myocardial infation

Question 7

myogloblin

Answer 7

• found in cardiac and skeletal muscle
• more rapidly released for infarcted myocardium than troponin
• high sensitivity but poor speciifcity

Question 8

natriuretic peptides

Answer 8

elevated BNP are independently associated with adverse outcomes-mortality

Question 9

symptoms of myocardial infarction

Answer 9

Pressure, tightness, or squeezing in chest or arm
Nausea, indigestion, heartburn, abdominal pain
Shortness of breath
Cold sweats
Fatigue
Dizziness.

Question 10

diagnosis of MI

Answer 10

• symptoms of ischaemia
• biomarkers
• ECG changes indicative of new ischaemia
• imaging evidence of new loos off viable myocardium

Question 11

which wave if the ECG will change

Answer 11

Q wave

Question 12

MI simple

Answer 12

Irreversible necrosis of a heart muscle due to a prolonged lack of oxygen supply (ischemia).

Question 13

angina

Answer 13

narrowing of the arteries caused by plaques

Question 14

full occlusion by plaque

Answer 14

MI

Question 15

half of the salvageable myocardium is lost within

Answer 15

1 hour. 2/3 lost within 3

Question 16

Myocardial myopathy

Answer 16

disease of the heart tissue- muscle becomes thick, rigid and enlarged

Question 17

three types of myocardial myopathy

Answer 17

• ARVC
• HCM
• DCM

Question 18

Hypertrophic cardiomyopathy (HCM)

Answer 18

a portion of theheartbecomes thickened without an obvious cause. This results in theheart is less able to pump blood effectively. Symptoms vary from none to feeling tired, leg swelling, and shortness of breath. It may also result in chest pain or fainting.

Question 19

HCM is

Answer 19

autosomal dominant, 1 in 500

- over 400 mutations in 9 genes

Question 20

HCM mutations

Answer 20

42% cardiac MyBP-C gene
40% cardiac beta myosin heavy chain
-around 50 down mutations

Question 21

diagnosis of HCM

Answer 21

• ECG
• Echocardiogram
• stress testing

Question 22

treatment for HCM

Answer 22

B blockers
Diuretics
Disopyramide

Question 23

Arrthymogenic right ventricular cardiomyopathy

Answer 23

Does not effect the muscle of the atria
Cells of the heart are held together by proteins
Thought that people with ARVC cannot keep the heart muscle cells together when under stress
Cells become detached and die
These cells become fibrous and cause scarring
Fatty deposits build up

Question 24

result of ARVC

Answer 24

walls of ventricles become thin and stretch and therefore cannot pump effectively
-also itnerups electrical impulses causing arrhythmias and sudden cardia death

Question 25

Naxos

Answer 25

a recessive association of ARVC with wooly hair and palmoplantar kertoderma.
- mutation in gene encoding desmosome associated protein plakoglobin