Ischaemic Heart Disease Flashcards
What the cardiac causes of the chest pain
MI Angina Pericarditis Aortic aneurysm Aortic dissection Mitral valve prolapse
Define mallory weiss syndrome
It is tear in the mucous membane or inner lining in escophagus ,where the esophagus meet the stomach
And can cause significant treatment
What difference between the pneumona and pneuoghorax ?
The pneumonia is infection in air ways or the air sac(alveoli)
The pneumothorax is the lung collapse by the air found in the plueral cavity cause mainly by chest injury or lung disease
The thoracic outlet syndrome ?
It is compression of the nerves and vessels between the first rib and clavicle bone ( thoracic outlet )
Lead to pain in the chest ,shoulder and neck
Whta the mian risk factors of IHD
Male gender Increasing age Family history of IHD Dyslipidaemia Hypertension Cigarette smoking Diabetes Mellitus Obesity Sedentary lifestyle
What the pathology of the MI
1-the chronic endothelial injury occur by the hypertension Tobacoo uses Hyperlipidemia Diabetes Toxins Infection
2-the inflammation initiate in the intima layer and lead to formation of the fatty steak
3-the fibrous cap covers the fatty steak and the lumen of the vessles become narrow
4-the the rupture in the fibrous cap lead to initate thrombosis formation and prograssive along the coronary artey
5-the first area that undergo to the necrosis is subendocardial because it compress first and relax last and also it away from the artery than epicardial area of myocardial layer
6-complete occlusion lead to the transmural nocrosis
7-the granulation tissue is form then the fibrous tissue replace the normal myocardial tissue
List the three types of angina and what their causes
Stable angina —–fixed stenosis in the coronary artery and mainly by fixed (not reptured ) artherosclerotic plaque
Variant (vasospasmtic )angina—cause by abnormal vasocontraction in the coronary artery
Unstable angina—-cause by the reptured artherosclerotic and prograssive thrombosis formation
Changes in ecg in
Stable angina
Unstable angina
NSTEMI
STEMI
stable anginn—–normal ecg at rest and may have ST dpression at stress conditions
Unstabel angina —varient change normal , T WAVE Invertion and st dpression
NSTEMI —–T WAVE invertion and ST dpresstion
STEMI——– ST elevation
What the mian difference between the stable and unstable angina
- The pain occur at physical activity or stress only in the patient with stable angina
- The pain occur at rest in patient with unstable angia
The pain relieve by GTN in stable angina but not unstable angina
In ECG in stable angina often see normal but in the unstable angina often see st dpression
Patient with MI may appear paler and sweaty and may have techycardia ,why?
That because abnormal activation of symapthetic branch
Patient with MI may appear paler and sweaty and may have techycardia ,why?
That because abnormal activation of symapthetic branch
Patient with MI May have vomiting and bradycardia ,why?
Because the parasymapthetic dysfunction
Patient may have oliguria ,hypotension ,cold extremeties ,narrow pulse pressure ,raised jvp
Quiet s1 and diffuse apical impulse, what that indicate ?
It Indicate impairing in myocadial function
Routes of investigation of MI?
CxR ECG ECHO Cardiac biomarkers Coronary angio
What the important cardiac biomarker in MI investigation
Creatine kinase
Troponin T and i
What the elevation of these biomarkers indicate ?
Myocardial infraction
The elevation of enzymes (CK,Troponin) indicate angina ?
True
False
False Myocardial infraction (irreversible injury)
What the benefit of the nitrovasodiators and calcium antagonists in managment of stable angina?
These drugs cause vasodiation and improve coronary prefusion
What the benefit of beta blocker in stable angina mangment ?
It decrease heart workout so decrease o2 demand
benefit of the asprin in decrease the risk of IHD?
It act as the vasodilstor and antithrombotic drug
Prevent platelets aggregation
What the benefit of statin drugs in decrease risk of IHD ?
Decrease the cholestrol in blood
What the meaning of revascularization and what the two types of surgical procedures use in revascularization?
Revascularization is restoration of perfusion to a body part or organ that has suffered ischemia
Two types of surgical procedures :
CABG
PCI
How difference bwtween the unstable and NSTEMI?
By cardiac biomarkers
If there are enzymes Elevation —–NSTEMI
If there are no enzymes elevation —-Unstable angina
Difine the acute coronary syndrome?
It relate to the group of the symptoms attributed to the obstruction of the coronary arteries .
ACS IS a result of
- unstable angina
- NSTEMI
- STEMI
Define pericaditits
pericarditis (an inflammation of the serous layer around the heart).
What the benefit of the ACEI In decrease the risk of MI?
It decrease the pressure by decrease the reabsorption of the water from kideny and act as vasodialtor
What cause of sound that the doctor may hear it in pateint with pericarditis ?
It is pericardial friction rub that cause by movment of inflamed pericardium
What the causes of pericarditis ?
Viral or bacerial infection
Post MI
malignant indisposition
Connective tissue disorders
