Ischaemic Heart Disease And

Question 0

Tachycardia greater than what beats per minute causes ischaemia?

Answer 0

Tachycardia >180 BPM – >

DECREASE FILLING time!!!!!!!!!!!! – >ischaemia

Question 1

What is ischaemic heart disease

Answer 1

Imbalance between

Myocardial oxygen DEMAND
SUPPLY of oxygen from coronary arteries

Question 2

Give the three main coronary artery is that can fuck up? Give the % of thrombosis.

Answer 2

LAD = 40–50%
Anterior LV, anterior 2/3 IVSeptum, apex

RCA = 30–40%
Posterior LV, posterior 1/3 IVSeptum, AV/SA node,
POST. MEDIAL PAPILLARY MUSCLE
RV via acute marginal

Left Circumflex = 15-20%
Lat wall of LV

Question 3

What protective mechanism does the heart do after slow occlusion by atherosclerosis

Answer 3

Slow occlusion atherosclerosis – >

COLLATERAL CIRCULATION –> MI protect

Question 4

What is the major cause of death in the world?
IHD in men or women more?
Types of IHD?

Answer 4

Ischaemic heart disease – myocardial infarction
Men >Women

Angina pectoris, Chronic HD, sudden cardiac death, acute MI

Question 5

Risk factors of IHD

Answer 5

LDL >160 mg/dL
HDL 45/55,

Diabetes mellitus
Age > 45+55, Tobacco
Hypertension

Question 6

Three types of angina pectoris?

Answer 6

Chronic stable
Prinzmetal variant
Unstable

Question 7

Explain risk factors of chronic stable angina pectoris

Answer 7

CASHH - secondary to atherosclerosis @ EXERTION

Cocaine induced CA vasoconstruction
Atherosclerotic fixed CAD (1/+ vessels obstructed stenosis severity > 70%!!!!!!!!!!!!!!!!!!!!!!!)
Stenosis AV/HTN + LVH
Hypertrophic cardiomyopathy

– >Chronic stable AP =
reversible injury – myocytes cellular swelling

Question 8

Explain pathphys of chronic stable AP

Answer 8

Sex, 
Temp = cold, 
Exercise, 
Meal heavy, 
Emotional stress

– >Decreased CA bloodflow + concentric thick wall –> SUBENDOCARDIAL ischaemia –>

Pain @left shoulder/arm/JAW
Exercise induced Substernal pain (30 sec – 30 mins)
numbness
Dyspnoea + diaphoresis –>

Resting/GTN spray = relief

Question 9

Explain Prinzmetal variant angina

Answer 9

Secondary to Atherosclerosis @ REST. Tet tct

ThxA2⬆️ from thrombus material over/not over atherosclerotic plaque=10%

⬆️endothelin

Trigger = tobacco cocaine triptans

–> intermittent CA VASOSPASM @ REST – >

Transmural ischaemia =

GTN + Ca2+ channel blockers + smoking cessation

Question 10

What is unstable/crescendo angina

Answer 10

MUltivessel, Fixed, Severe atherosclerotic plaque ->

Plaque rupture – >

thrombosis + incomplete CA occlusion –>

Subendocardial ischaemia = GTN

Question 11

ECG readings of all the anginas?

Answer 11

SUBendocardial ischaemia –
chronic stable/unstable crescendo = ST depression

Transmural ischaemia – Prinzmetal variant
= ST elevation

Question 12

What kind of people get angina pectoris?

Answer 12

Middle-aged/elderly

1 year stable Angina – >10/20% get MI/unstable angina

Menopause

Question 13

What is sudden cardiac death

Answer 13

Unexpected death from cardiac causes in people

Without symptomatic heart disease
Within one hour after symptomatic onset

Question 14

Coronary artery causes for IHD sudden cardiac deTh

Answer 14

Glucose intolerance
Obesity
Smoking
Hyperlipidaemia

HTN, LVH, NSTEMI

Question 15

None coronary artery causes for IHD sudden cardiac death

Answer 15

Cardiomyopathy, cocaine, conduction problem
AV stenosis
Mitral valve prolapse, myocarditis

CarCoCon

Question 16

What is the pathophysiology of sudden cardiac death

Answer 16

Lethal arrhythmias – ventricular tachycardia 75%

Question 17

Explain chronic ischaemic heart disease

Answer 17

Long-term ischaemic damage to myocardium – >

Myocardial tissue replaced by
noncontractile scar tissue