ischemia and HTN Flashcards
What is atherosclerosis?
Deposition of cholesterol and lipid laden plaques in vessel walls
What is acute coronary syndrome?
Condition brought on by sudden reduced flow to the heart
What are examples of acute coronary syndrome?
Angina, MI (STEMI or NSTEMI), sudden death
Describe the EKG changes and cardiac markers seen in unstable angina.
None!
Describe EKG changes and cardiac markers seen in NSTEMI.
No changes but elevated markers
Describe EKG changes and cardiac markers seen in STEMI.
Positive EKG changes as well as elevated cardiac markers
What is angina pectoris? What are the subtypes?
Chest pain. Stable, unstable, or variant
What groups may have abnormal presentation in terms of chest pain?
Women and diabetics
MI is often due to what underlying pathology?
Atherosclerosis, specifically disruption of the plaque leading to thrombus formation
What 3 factors cause death after MI within a few days?
Arrhythmia, pump failure/shock, rupture
After infarct, irreversible damage occurs after ___ minutes.
20-40
What area of the heart is most predisposed to damage?
Subendocardial as it is farthest from vessels and most prone to ischemia
Transmural infarct involves ___% of wall thickness.
Greater than 50%
Describe the heart 0-12 hours post MI.
Some dark mottling, coagulation necrosis, edema, hemorrhage
Describe the heart 12-24 hours post MI.
Dark mottling, coagulation necrosis, pyknosis, contraction bands, neutrophilic infiltration
Describe the heart 1-3 days post MI.
Yellow-tan mottling, coagulation necrosis with loss of nuclei and striations, neutrophils
Describe the heart 3-7 days post MI.
Yellow-tan softening, disintegration of dead myofibers, dying neutrophils, phagocytosis of dead cells at infarct border
describe the heart 10-14 days post MI
red-gray depressed infarct borders with well established granulation tissue, new vessels, and collagen
describe the heart 2-8 weeks post MI
gray-white scar with increased collagen deposition and decreased cellularity
at what point is scarring after an MI complete
2 months
What are contraction bands?
Structures in heart muscle that can be seen as a result of infarct within 12 hours after the event; present before the cells start to die
Yellowish discoloration in the heart muscle indicates ___, while gray discoloration indicates ___.
Necrosis vs granulation tissue
When does granulation tissue begin forming after an MI?
1-2 weeks
How long does it take to fully scar after an MI?
2 months; can’t tell the difference between an MI 2 months ago vs 20 years ago!
What are some subacute/acute complications of MI?
Pericarditis, reinfarction, rupture
What are some chronic complications of MI?
Aneurysm/thinning, mural thrombosis, HF, heart block
What blood pressure is considered hypertensive?
130/80
What does hypertension increase risk of?
Atherosclerosis, chronic kidney disease, stroke, dissection
What is the most common surgically correctable cause of HTN?
Renal artery stenosis
What factors cause cardiac hypertrophy?
Hypertension, valve disease, cardiomyopathies, obesity, stimulant use
What is the normal weight of the heart?
350-400 g
