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Patho CVS > IHD > Flashcards

IHD Flashcards

1
Q

Mention each type and cause of ischemia

A

⬆️demand:⬆️hypertension
⬇️supply: hypotension / shock
⬇️oxygenation : pneumonia or CHF
⬇️oxygen carrying capacity:anemia

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2
Q

Define angina

A

Ischemic induced pain that doesn’t cause myocytes death

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3
Q

When cell death occurs in heart due ischemia the clinical manifestation is present as

A

MI

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4
Q

Sudden cardiac death is caused by

A

After MI or due to lethal arrhythmia

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5
Q

What is the acute clinical presentation of IHD

A

Acute coronary syndrome : catastrophic manifestations
of unstable angina, acute MI, and SCD

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6
Q

Ratios of obstruction in stable and unstable angina

A

70-75% stable
90% unstable which results in MI or sudden death

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7
Q

Ischemia induce which molecules to induce autonomic afferent

A

Adenosine and bradykinin

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8
Q

Types of angina

A

Typical/ stable
Crescendo/unstable
Prinzmetal/variant

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9
Q

Which type of angina Responds to vasodilators such as nitroglycerin and calcium channel
blockers.

A

Variant

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10
Q

Variant angina occurs at

A
  • Occurs at rest
  • Caused by coronary artery spasm.
  • Completely normal vessel can be affected.
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11
Q

Episodic chest pain associated with particular levels of exertion
- Crushing or squeezing substernal sensation, that can radiate down the
left arm or to the left jaw (referred pain)
All indicate which type of angina and can be solved

A

Typical
By rest (reducing demand) or by drugs such as
nitroglycerin (vasodilator

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12
Q

Which type of angina is Associated with plaque disruption and superimposed thrombosis,and/or vasospasm.

A

Unstable

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13
Q

Unstable occurs at

A

Increasingly frequent pain, precipitated by progressively less exertion or
even occurring at rest.

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14
Q

Calcium channel blockers can be used in which type of angina

A

Variant

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15
Q

Risk factors of MI

A

Atherosclerosis and increased age( occurs at any age) and DM

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16
Q

Myocardial chemical response to ischemia

A

Within seconds of vascular obstruction: aerobic
glycolysis ceases drop in ATP➡️
accumulation of potentially noxious metabolites
(e.g., lactic acid) in the cardiac myocytes.

17
Q

Due to drop in atp myocardial cells will lose the ability to

A

Contract

18
Q

Within few minutes of ischemia which Ultrastructural changes occur

A

myofibrillar relaxation, glycogen depletion, cell
and mitochondrial swelling
These early changes are potentially reversible.

19
Q

Severe ischemia lasting

A

20-40min

20
Q

irreversible damage and coagulative necrosis of myocardium indicates

A

Severe ischemia

21
Q

Irreversible injury of ischemic myocytes first
occurs in

A

subendocardial zone:
- The last area to receive blood delivered by the
epicardial vessels

22
Q

infarct usually achieving its full extent within 3 to 6 hours

A

3 to 6 hours

23
Q

Describe the difference between myocardial , infraction types in terms of thickness

A

Transmural Involve the full thickness of the ventricle while Subendocardial limited to the inner third of the myocardium

24
Q

Non-ST elevation infarcts is characteristic of

A

Subendocardial infarction

25
Q

features of an acute MI depend on:

A

The size and distribution of the involved vessel
- The rate of development and the duration of
the occlusion
- Metabolic demands of the myocardium
- Extent of collateral supply

26
Q

Vessels involved in 40% to 50% of all MI

A

proximal left anterior descending (LAD)
artery occlusion

27
Q

Vessel that result, in infraction in most of right ventricle

A

30% to 40%: Proximal right
coronary artery (RCA)

28
Q

Infraction of the left lateral ventricle is caused by

A

15% to 20% : proximal left
circumflex (LCX) artery

29
Q

Silent infarcts percentages

A

10% to 15%of MIs
- Common in diabetes mellitus
- Elderly.

30
Q

Describe MI pain

A

Pain typically lasts several
minutes to hours, and is not
relieved by nitroglycerin or
rest.

31
Q

Clinical futures of MI

A

Severe, crushing substernal
chest pain (or pressure) that
can radiate to the neck, jaw,
epigastrium, or left arm.

The pulse generally is rapid and weak, and
patients are often diaphoretic and nauseous .
• With massive MIs (involving more than 40% of
the left ventricle): cardiogenic shock
develops. And severe hypotension

32
Q

Q waves, ST segment changes, and T wave
inversions
• Arrhythmias
And cardiac enzymes
All indications of??????

A

MI

33
Q

death rate for MI

A

7%

34
Q

A 1/3 of persons with (??????) will die, usually
of an arrhythmia within an hour of symptom
onset.

A

STEMI.
ST segment elevation MI

Patho CVS (6 decks)

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