Ischemia Flashcards
Name the branches of the coronary arteries
- Left Anterior Descending
- Left Circumflex
- Right coronary Artery
What does the LAD supply
- LAD supplies blood to anterior wall of LV, IVS, and Apex
What does LCX supply
Supplies blood to the lateral and posterior portion of LV
What does RCA supply
Rv and inferior wall of LV
Name the base segments of LV 1-6
1) basal anterior wall
2) basal anteroseptal wall
3) basal inferoseptal wall
4) basal inferior wall
5) basal inferolateral wall
6) basal anterolateral wall
Name the mid segments of the LV 7-12
7) mid anterior wall
8) mid anteroseptal wall
9) mid inferoseptal wall
10) mid inferior wall
11) mid inferolateral wall
12) mid anterolateral wall
Name the apex segments of the Lv 13-16
13) apical anterior wall
14) apical septal wall
15) apical inferior wall
16) apical lateral wall
On 4ch, what coronary arteries share supply
- LAD and CX share supply on the lateral walls
- RCA and LAD share supply on septal walls
What CA’s share blood supply on 3ch
RCA and CX on inferolateral walls
What is myocardial ischemia
- inadequate bloody supply vs o2 demand
- leads to loss of normal contractile performance (hypokinesis)
2 types of coronary artery disease
Arteriosclerosis: abnormal thickening and hardening of vessel walls
Atherosclerosis: a form of arteriosclerosis which is thickening of vessel walls due to a buildup of lipids
Symptoms of CAD
- CP
- SOB
- Fatigue and Weakness
- palpitations
- edema
What are the risk factors that could can CAD
- smoking
- Hypertension
- hyperlidiema
- family history of cad
- diabetes
- Obesity
What are collateral coronary arteries
- network of tiny blood vessels that are not open under normal conditions
- activate if CA’s narrow too much
What are the 4 types of diagnostic testing for CAD
1) electrocardiogram
2) stress testing
3) coronary angiography
4) noninvasive imaging of coronary arteries
What are the 2 types of stress testing
1) physiologic stress exam
2) pharmacological stress exam
What pharmacologic drugs are used for stress testing
- dobutamine (vasodilator)
- inotrope (contractility)
- atropine (increase heart rate if dobutamine is not enough to get to max heart rate)
Myocardial injury’s affect
- injured cells will die unless blood flow can be restored
- tissue death (necrosis)
What are infarcted cells
- cannot respond to electrical impulses
- do not provide any mechanical function
What is transmural MI
- when the entire myocardium is affected and damaged from a MI
What is subendocardial MI
When the innermost layers of the myocardium are damaged from an MI
What angina pectoris
- chest pain
- occurs when heart muscle isn’t Getting as much blood as it needs (ischemia)
What are signs of acute coronary syndrome
- ST segment elevation myocardial infarction (STEMI)
- Non ST segment myocardial infarction (NSTEMI)
- aortic dissection
- pericarditis
- pulmonary embolism
What specific cardiac bio markers detect myocardial necrosis
- Troponin (protein that help the muscle contract)
- Creatine kinase (enzymes released in blood if have an MI)
What is an angiography
A medical diagnostic technique to visualize the the inside, or lumen, or blood vessels and organs of the body
What is a percutaneous coronary intervention
A stent being placed within the coronary arteries
Used to treat atherosclerosis
How can we evaluate acs with echo
- evaluate regional wall motion abnormalities
- estimate EF
- evaluate cardiac hemodynamics: diastolic dys, pulmonary pressures, cardiac output
