Ischaemic Heart Disease and Hypoxia Flashcards

Question

blood clots in coronary arteries can grow to cause?

Answer 1

acute coronary occlusion

Answer 2

dilate within seconds, doubling by every 2nd or 3rd day usually reaching normal coronary flow in 1 month

Answer 3

“natural bypasses,” anastomotic connections w/o an intervening capillary bed between portions of the same coronary artery and between different coronary arteries

Answer 4

Slow occlusion-collateral vessels can develop at the same time while the atherosclerosis becomes more and more severe.

Answer 5

collaterals can also get atherosclerosis or damage is so extensive that even collaterals can't help > can cause weakening of the heart > HF

Answer 6

infarction

Answer 7

Small amount of collaterals open + blood seep into the infarcted area > local blood vessels dilate and area becomes overfilled with stagnant blood > muscle uses all O2, Hb > deoxy & blood vessels appear engorged despite lack of blood flow

Answer 8

Vessels walls permeability increases, fluid leak and local tissue oedematous Cardiac muscle cells swell and due to no blood supply die within few hours

Answer 9

decreased cardiac output - systolic stretch and cardiac shock, damming of blood in venous system, ventricle fibrillation, rupture of infarcted area

Answer 10

little or no death of muscle. Might become non functional temporarily due to lack of nutrients

Answer 11

Some in the centre die rapidly within 1 to 3 hours due to complete loss of blood supply Immediately around is non functional area failure of contraction and impulse conduction Surrounding non-functional still contracting but weak due to mild ischemia

Answer 12

JBS3 | QRISK

Answer 13

symptoms: chest pain type, associated symptoms and signs, age, sex, ethnicity, smoking, FH

Answer 14

heart auscultation BP BMI GPE

Answer 15

``` LDL HDL triglycerides lipoprotein A C reactive proteins ```

Answer 16

Troponins (I or T) Creatine kinase with MB isozymes Lactate dehydrogenase and lactate dehydrogenase isozymes Serum aspartate aminotransferase

Answer 17

``` B-type natriuretic peptide CRP Homocysteine Renin Urinary albumin-to-creatinine ratio ```

Answer 18

Pretty much normal ECG if you want to see the changes do an exercise stress test During stress test might see ST depressions indicating IHD

Answer 19

ST depression and T wave inversion

Answer 20

ST elevation with T wave inversion | Q waves

Answer 21

left ventricular function wall-motion abnormalities in the setting of ACS or AMI mechanical complications of AMI

Answer 22

possible aortic dissection in the setting of AMI

Answer 23

evaluate hemodynamically significant stenoses in stable patients who are thought to have CAD

Answer 24

iodinated contrast agent injected through catheter placed at ostium of coronaries > contrast visualized through radiographic fluoroscopic heart examination

Answer 25

detecting stenoses that may be revascularized through percutaneous or surgical intervention

Answer 26

the common and internal carotid arteries is a noninvasive measure of arterial wall in asymptomatic individuals > combined thickness of the intima + media associated w/ prevalence of cardiovascular risk factors and ^ risk of MI + stroke

Answer 27

for measuring coronary flow in humans

Answer 28

``` HMG-CoA reductase inhibitors Bile Acid sequestrants calcium channel blockers ACE inhibitors betablockers anti-anginal agents platelet aggregate inhibitors nitrates ```

Answer 29

percutaneous coronary intervention (angiohgraphy + stent) | CABG (vessel from somewhere else used to make a graft)

Answer 30

``` physical activity avoid smoking balanced healthy diet maintain a normal body weight reduce stress ```