IHD Flashcards
What is the progression of events when a cardiac arrest occurs?
MI -> Arrhythmia-> Asystole
Briefly describe Kawasaki Disease
Inflammation of the walls of medium sized arteries, including CAs
Typically in kids
May cause a MI
Compare and contrast STEMI and NSTEMI
- STEMI: transmural (the whole thickness of the muscle, endocardium to epicardium) with ST elevation
- NSTEMI: only a zone of ischemia with a small zone of cell death, causes a depressed ST segment
A basal septal focal hypertrophy
Sigmoid septum
True vs pseudoaneurysm
True aneurysms have thin walls and wide necks
Pseudoaneurysms occur where the wall ruptures and have a narrow neck
Compare and contrast STEMI and NSTEMI
- STEMI: transmural (the whole thickness of the muscle, endocardium to epicardium) with ST elevation
- NSTEMI: only a zone of ischemia with a small zone of cell death, causes a depressed ST segment
What is another name for microvascular angina?
Cardiac syndrome x
Define ischemic heart disease
A blockage in the coronary artery that is sufficient enough to prevent enough blood and oxygen supply to the myocardium
Name 5 non-atherosclerotic causes of IHD
- Cocaine/amphetamines
- Radiation therapy
- Coronary spasm
- Arteritis/vasculitis
- Trauma
- Embolus into CA
What are the 2 types of MI?
STEMI and NSTEMI
Compare and contrast stable/unstable angina
- Stable: predictable and regular, cause by stable plaque, manageable with meds/rest
- Unstable: more intense, not predictable, may be from plaque rupture, may require immediate procedure (bypass or PCI)
Two most common symptoms in Ischemic heart disease
SOB and angina
Name 5 non-atherosclerotic causes of IHD
- Cocaine/amphetamines
- Radiation therapy
- Coronary spasm
- Arteritis/vasculitis
- Trauma
- Embolus into CA
What is a benefit for using a beta blocker in patients with Ischemic heart disease?
It lowers heart rate so it will offset the normal tachycardia that happens when SV and CO drops in IHD.
Acute pericarditis vs Dressler’s Syndrome
Acute: 1-4 days post MI due to autoimmune response
Dressler’s: delayed pericarditis, 1-8 weeks post MI
What’s a PCI?
Angioplasty with stenting
True vs pseudoaneurysm
True aneurysms have thin walls and wide necks
Pseudoaneurysms occur where the wall ruptures and have a narrow neck
A basal septal focal hypertrophy
Sigmoid septum
Why are nitrates given to cardiac patients?
It is a powerful vasodilator that can help more flow travel through a blocked area. It also lowers the afterload due to peripheral vasodilation.
What are the 2 categories of IHD etiology. Which is most common?
Atherosclerotic: more common
Non-atherosclerotic
What is the gold standard for diagnosing IHD?
Coronary angiogram
What is another name for microvascular angina?
Cardiac syndrome x
Elevated ST segment
STEMI
Define ischemic heart disease
A blockage in the coronary artery that is sufficient enough to prevent enough blood and oxygen supply to the myocardium
Ischemia vs infarction
Ischemia is a lack of blood and oxygen supply
Infarction is ischemia that has progressed to the point of damage
What is a CABG? What vessel is usually harvested for it?
It is open heart surgery (bypass). Usually the GSV
Reasons to slow the HR
- More ventricular filling
- The CA can fill longer as they only fill during diastole
- Lowers BP
- Lowers afterload
- Lowers oxygen demand
When does cell death start to happen in an infarction?
Starts within 1 hour and is complete by 4 hours
Depressed ST segment
NSTEMI
Depressed ST segment
NSTEMI
When does cell death start to happen in an infarction?
Starts within 1 hour and is complete by 4 hours
What are the 2 categories of IHD etiology. Which is most common?
Atherosclerotic: more common
Non-atherosclerotic
What is a CABG? What vessel is usually harvested for it?
It is open heart surgery (bypass). Usually the GSV
What is the progression of events when a cardiac arrest occurs?
MI -> Arrhythmia-> Asystole
What’s a PCI?
Angioplasty with stenting
Arrhythmia that usually precedes cardiac arrest (asystole)
Ventricular tachycardia (VT)
Acute pericarditis vs Dressler’s Syndrome
Acute: 1-4 days post MI due to autoimmune response
Dressler’s: delayed pericarditis, 1-8 weeks post MI
What is Variant Angina/Prinzmetal’s Angina?
Caused by coronary artery spasm between 1-6am
What are 4 post MI complications?
- MR due to pap muscle dysfunction
- Thrombus
- Aneurysms
- Pericarditis
- Acquired VSD
- CHF
- Ventricular arrhythmia
What is Variant Angina/Prinzmetal’s Angina?
Caused by coronary artery spasm between 1-6am
Ischemia vs infarction
Ischemia is a lack of blood and oxygen supply
Infarction is ischemia that has progressed to the point of damage
Compare and contrast stable/unstable angina
- Stable: predictable and regular, cause by stable plaque, manageable with meds/rest
- Unstable: more intense, not predictable, may be from plaque rupture, may require immediate procedure (bypass or PCI)
Elevated ST segment
STEMI
What are some risk factors of IHD?
Age, smoking, diabetes, HTN, dyslipidemia, obesity, family history, sedentary lifestyle
What is the gold standard for diagnosing IHD?
Coronary angiogram
What are the 2 types of MI?
STEMI and NSTEMI
What are some risk factors of IHD?
Age, smoking, diabetes, HTN, dyslipidemia, obesity, family history, sedentary lifestyle
What are 4 post MI complications?
- MR due to pap muscle dysfunction
- Thrombus
- Aneurysms
- Pericarditis
- Acquired VSD
- CHF
- Ventricular arrhythmia
Briefly describe Kawasaki Disease
Inflammation of the walls of medium sized arteries, including CAs
Typically in kids
May cause a MI
The biggest difference between stable and unstable angina
Unstable angina is not predictable and can be more severe
