Ischaemic Heart Disease/HTN Flashcards
normal bp
<80
prehypertensive
120-139/80-89
hypertensive I
140-160/90-99
hypertension II
> 160/>100
list risk factors of developing essential hypertension
related to increased CO and increased TPR age obesity diabetes physical inactivity excess salt intake excess alcohol intake family history black>white> asian
describe acute end organ damage
encephalopathy stroke retinal hemorrhages, exudats, hemorrhages MI HF aortic dissection
hypertensive predisposes to:
coronary artery disease LVH HF atrial fibrillation aortic dissection aortic aneurysm stroke chronic kidney disase retinopathy
signs of hyperlipidemia
xanthomas, tendinous sxanthoma, corneal arcus
hyaline arteriosclerosis
diabetes and essential hypertension due to thicekenign of vessel walsl - leaking
hyperplastic hypertension
onion skinning in severe hypertension due to proliferation of smooth muscle cells.
what is monckeberg?
medial calcific sclerosis affects medium sized arteries calcification of elastic lamina of arteris - stiffening without cobstriuction PIPESTEM on CXR no obstruction fo blood flow intima is not involved
describe what vessels atherosclerosis affects
elastic arteries
large and medium sized muscular arteries
a form of arteriosclerosis caused by buildup of cholesterol plaques
risk factors
modifiable: smoking, hypertension, hyperlipidemia, diabetes
nonmodifiable: age, sex - men and post menopausal women, family history
describe progressin of atherosclerosis
inflammation tis important
endothelia cell dysfunction – MO and LDL accumulation – foam cell formation – fatty streaks – smooth muscle cell migration (PDGF, and FGF) – proliferation and extracellular matrix deposition – fibrous plaque – complex atheromas when calcified
complciations of atherscloersis
aneurysms, ischemia, infarcts, peripheral vascular disease, thrombus, emboi
most common locatiosn of atherosclerosi
abdominal aorta > carotid arteries > popliteal artery > coronary artery
symptoms of atherosclerosis
angina, claudication, ASXTIC MOSTLY
abdominal aorti aneurysm associated with?
atherosclerosis
RF for abdominal aortic aneurysm
tobacco use
increased age
male
family history
RF for thoracic aortic aneurysms
hypertension
bicuspid aortic valve
Marfan
tertiary syphillis
assicated with aortic diseection are?
hypertension
bicuspid aortic valve
marfan
same as thoracic aneurysm minus syphillis
what is an aortic dissection?
longitudinal intimal tear forming a false lumen -
cxpx of aortic dissection?
tearing chest pain of acute onset radiating to the back with or without markedly unequal bp in arms
standor type A aortic dissecation
ascending aorta and may extend to aortic arch fo descending aorta
treatment is surgery
Stanford type B aortic dissection
descending and or aortic arch, no ascending
treat with beta blockers then vasodilators
complicatiosn of aortic dissection
rupture
pericardial tamponade
fatal
describe stable angina
secondary to atherosclerosis
extertional chest pain in classic disctribugion
ST depression
resolves with rest or NO
describe variant angina
occurs at rest secondary to vascular spasm
transient ST elevation
triggers: tobacco, cocaine, triptans
treat with CCB, nitrates, smoking cessation
describe unstable angina
thrombobsis with incomplete coronary artery occution
with or without ST elevation and or T wave inversion
no cardiac biomarker elevation
increased frequency or intesnsitiy of chest pain or any chest pain at rest
coronary steal syndrome
distal to coronary stenosis vessels are maximally dialted at baseline. so if give casodilators - dilates normal vessels and shunts blood away from post stenotic region resulting in decreased flow and iscahemia
STRESS TEST
myocardial infarction
most often due to acute thrombosis due to rupture of coronary artery atherosclerotic plaque
ECG in transmural MI
STEMI elevated + cardiac biomarkers
ECK in subendocardiacl MI
NSTEMI depressed + Cardiac biomarkers
sudden cardiac death
death from cardiac causes within one hour of onset of symptoms.
most commonly due to lethal arrhythmia
associated with CAD, cardiomyopathy, hereditary ion channelopathies