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Cardiopulm > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

acute coronary syndrome (ACS)

A
  • umbrella term for symptoms associated with sudden, reduced blood flow to heart
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2
Q

What conditions are included in ACS diagnosis?

A
  1. MI
  2. unstable angina
  3. STEMI
  4. NSTEMI
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3
Q

ACS diagnosis is dependent on:

A
  • patient hx of chest or left arm pain
  • hx of CAD
  • exam findings
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4
Q

ACS exam findings

A
  1. hypotension, diaphoresis
  2. pulmonary edema, rales
  3. ST seg deviation
  4. Elevated biomarkers
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5
Q

Ischemic heart disease includes

A
  • heart attack

- stable or unstable angina

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6
Q

IHD causes

A
  1. atherosclerosis of coronary arteries
  2. coronary thrombus or emboli
  3. coronary spasm
  4. complications of conn tissue disorders
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7
Q

IHD risk factors

A
  • age
  • HTN
  • DM
  • Gender
  • Smoking Hx
  • Physical inactivity
  • Obesity
  • Hypercholestermia
  • Hyperlipedemia
  • High stress
  • family hx
  • poor diet
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8
Q

IHD common symptoms

A
  1. chest p! or discomfort
  2. p! or discomfort in one or both arms, jaw, neck, back, or stomach
  3. SOB
  4. dizziness/lightheaded
  5. nausea
  6. sweating (diaphoresis)
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9
Q

IHD blood testing

A
  1. cardiac enzymes
  2. c reactive protein
  3. homocysteine
  4. abdnormal lipid profile
  5. brain natriuretic peptide (BNP)
  6. prothrombin
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10
Q

Ischemic cardiomyopathy

A
  1. caused by narrowing of coronary arteries, diminished blood supply to heart.
  2. most common type of dilated cardiomyopathy
  3. caused by CAD
  4. constant cardiac ischemia = irreversible myocyte damage
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11
Q

Ischemic cardiomyopathy:

cardiac remodeling

A
  1. myocardial fibrosis
  2. possible cardiac conduction system impairment
  3. cell death
  4. LV enlargement and dilation
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12
Q

HF due to ischemic cardiomyopathy

A
  1. most common presentation for ischemic cardiomyopathy

2. prognosis determined by myocardial viability

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13
Q

Rheumatoid CA disease

A

patients with rheumatoid arhtritis have 2-3X more epicardial and small vessel CAD

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14
Q

Angina pectoris

A

stable and unstable

intermittent chest p! caused by transient, reversible myocardial ischemia

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15
Q

angina pectoris leads to

A
  • MI
  • Sudden cardiac death
  • ischemic cardiomyopathy
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16
Q

stable angina

A
  1. caused by mismatch between O2 delivery and need
  2. brought on by exertion/stress
  3. predictable HR
  4. crushing or squeezing substernal sensation w/possible radiation down L arm
  5. reduction in stress reduces symptoms
17
Q

treatment for stable angina

A

nitroglycerin

causes systemic vasodilation

18
Q

unstable angina

A
  • exertion/stress
  • unpredictable onset
  • crushing or squeezing substernal sensation w/possible radiation down L arm
  • poor prognosis
19
Q

IHD:

plaque rupture

A
  • exposes thrombogenic lipids to blood

- stimulates localized thrombus formation with ischemic outcomes

20
Q

IHD:

Occlusive event

A

damage dependent on CA involved and time before treatment

21
Q

MI:

stages (0-7 days)

A

0-6 hrs: no change

6-24 hrs: early features coagulative necrosis

1-4 days: coagulative necrosis w/acute inflammatory response

5-7 days: macrophage activity

22
Q

MI:

stages (7 days-3 mo)

A

7-10 days: developing peripheral rim of granulation tissue

1-6 weeks: progressive organization of infarct

1-3 months: progressive collagen deposition, mature replacement scar

23
Q

MI:

area of injury becomes a scar, leading to:

A
  • wall movement issues

- electrical propagation issues

24
Q

Reperfusion injury

A

tissue damage when blood returns to tissue after a period of ischemia or lack of O2

associated with microvascular injury

25
Q

Sudden cardiac death

A
  • 50% of deaths from CAD
  • V fib, asystole (flat line)
  • acute coronary plaque rupture/thrombosis
  • clinically quiet MI
  • No acute lesion but >60% stenosis of a CA

Cardiopulm (20 decks)

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