Ischaemia and Infarction Flashcards
What is low flow infarction?
Low flow infarction occurs in cardiovascular shock when blood lost due to trauma leads to insufficient blood being pumped to the tissues.
What are the 3 most significant causes of ischaemia?
Atheroma, Thrombosis, Embolism
Why will vasculitis lead to acute ischaemic damages?
Inflamed vessels tend to thrombose. Hence, thrombosis may occur, leading to ischaemic damages
What is the cause of Raynaud’s disease?
Spasm of blood vessels leads to ischaemia.
What is Cryoglobulinaemia?
A medical condition where the blood carries large amounts of cryoglobulin - proteins that becomes insoluble at reduced temperatures
Define cardiac sudden death
An unexpected death due to heart problems that occur within 1 hour from the start of any cardiac related symptoms.
What are the 2 possible causes of cardiac sudden death?
Massive Transmural acute myocardial infarction and fatal arrhythmia (eg. VF)
Define angina pectoris
Paroxysmal and usually recurrent attacks of precordial chest discomfort (constricting, squeezing) caused by transient (15secs to 15mins) myocardial ischaemia that falls short to induce cellular necrosis.
What is another term for ‘crescendo angina’?
Unstable angina
Describe Prinzmetal angina
Angina due to transient spasm of artery with severe atheromatosis.
What are the 2 types of NSTEMI?
ST depression and T inversion
What is the difference between NSTEMI and STEMI in terms of their causes?
In NSTEMI, there is incomplete or transient occlusion.
In STEMI, there is complete and sustained occlusion.
How is unstable angina different from other NSTEMI?
There are no elevated biomarkers of myocardial necrosis in unstable angina.
But in NSTEMI, there is elevated biomarkers of myocardial necrosis.
What are the 2 types of MI and which is a more common one?
Subendocardial MI and Transmural MI.
Transmural MI is the more common one.
What is dissecting aneurysm?
Dissecting aneurysm is an initial tear that develops in the vessel, allowing blood to track into the media.
What are the presentations of right-sided heart failure?
Peripheral oedema, hepatic congestion and raised JVP.
What does “Nutmeg appearance” indicate?
Hepatic congestion (and Right sided Heart Failure)
What is Charcot Bouchard aneurysms?
Capillary Microanuerysm
What type of infection can lead to mycotic aneurysm?
Bacterial or fungal infection.
What is the difference between focal ischaemia and global ischaemia?
Focal ischaemia - part of the brain’s blood supply is disrupted. Focal complete tissue necrosis possible, depending on time.
Global ischaemia - total stoppage of blood perfusion in the brain. Pan-necrosis or selective neuronal necrosis possible depending on time. (selective neuronal necrosis is when some brain areas are more vulnerable to global ischaemia than others.)
Lacunar infarcts are often related to which condition?
Small vessel disease (due to chronic hypertension) is a disease that arise when the walls of the small arteries are damaged, resulting in signs such as angina.
What does 1 pack year means (smoking history)?
Smoking 20 per day for 1 year
What are the three features of a “typical angina pain”?
- Constricting discomfort on the chest, arms, shoulder, or jaw
- Caused with physical exertion
- Relieved with rest or GTN spray within 5mins
What are the features of pericarditis?
Sharp, stabbing central chest pain. Worse on lying flat and relieved by sitting forward
