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Pathophysiology > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

ischemia

A

condition in which blood flow is restricted or reduced in or to a part of the body

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2
Q

hypoxemia

A
  • low oxygen content in the blood

- low O2 saturation

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3
Q

hypoxia

A
  • body or a region of the body is deprived of adequate oxygen supply at the tissue level
  • fully saturated blood but not getting to area needed
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4
Q

acute coronary syndrome

A
  • umbrella term for a range of symptoms associated with sudden, reduced blood flow to the heart
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5
Q

what does acute coronary syndrome include

A 
MI
unstable angina
ST segment elevation
non-ST segment elevation
myocardial infarction or heart attack
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6
Q

is ACS a diagnosis?

A

yes

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7
Q

patient history for someone with ACS

A

chest or left arm pain, hx of CAD

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8
Q

examination of someone with ACS

A
  • hypotension, diaphoresis
  • pulmonary edema, rales
  • ECG changes
  • elevated cardiac biomarkers
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9
Q

ischemic heart disease

A
  • coronary heart disease
  • coronary artery disease
  • atherosclerotic heart disease
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10
Q

what does ischemic heart disease include

A

heart attacks/MI

angina: stable or unstable

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11
Q

what is the most common specific diagnosis under ACS

A

ischemic heart disease (IHD)

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12
Q

causes of IHD

A
  • atherosclerosis of the coronary arteries
  • coronary thrombus or emboli
  • coronary spasm
  • complications of connective tissue disorders
  • lupus
  • RA
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13
Q

risk factors IHD

A 
age
HTN
diabetes
gender
smoking
physical inactivity
hypercholestermia/hyperlipidemia
high levels of stress
family history
poor diet
obesity
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14
Q

symptoms of IHD

A
  • chest pain
  • pain in arms, jaw, neck, back or stomach
  • SOB
  • lightheaded
  • nausea
  • sweating
  • females present diff than males
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15
Q

how can IHD be diagnosed

A

blood testing

  • cardiac enzymes, troponin, ANP & BNP are gold standard
  • CRP
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16
Q

plaque rupture

A
  • exposes thrombogenic lipids to the blood

- stimulates localized thrombus formation with ischemic outcome

17
Q

occlusion event

A

damage is dependent on coronary involved

18
Q

cardiomyopathy

A

disease of the heart muscle

19
Q

ischemic cardiomyopathy

A
  • heart is chronically ischemic
  • chronic narrowing of the coronary arteries which in turn, diminishes blood supply to the heart
  • most common type of dilated cardiomyopathy
20
Q

what causes ischemic cardiomyopathy

A

CAD which causes an insufficient blood flow to the heart resulting in myocyte ischemia

21
Q

the damage from the myocyte ischemia when you have ischemic cardiomyopathy causes what?

A
  • cardiac remodeling
  • myocardial fibrosis
  • arrhythmias
  • possible cardia conduction system impairments
  • cell death
  • left ventricular enlargement and dilation
22
Q

what is a precursor for ischemic cardiomyopathy

A

worsening CAD

23
Q

pt’s with ischemic cardiomyopathy develop what

A
  • congestive heart failure

- most common presentation

24
Q

prognosis for ischemic cardiomyopathy

A

determined by myocardial viability (number of functioning myocytes)

25
Q

rheumatoid arthritis

A
  • immune mediate chronic inflammatory disease

- morning stiffness, arthralgias, arthritis

26
Q

rheumatoid arthritis can appear as

A 
pericarditis
myocarditis
valvular heart disease
atherosclerotic CAD
coronary arteritis
aortitis
cor pulmonale
conduction disturbances
27
Q

rheumatoid arthritis is a primary pathogenic factor for what

A

premature development of atherosclerosis –> pulmonary HTN –> cor pulmonale

28
Q

angina pectoris

A

intermittent chest pain caused by transient, reversible myocardial ischemia

29
Q

angina leads to what

A

MI
sudden cardiac death
ischemic cardiomyopathy

30
Q

stable angina

A
  • mismatch between O2 delivery and O2 need

- heart wants to pump blood but no O2 available so presents as angina

31
Q

how is stable angina brought on

A
  • by exertion or other form of stress and reduces with reduced stress
  • occurs at a predictable HR
32
Q

unstable angina

A
  • brought on by exertion or other form of stress

- onset is unpredictable

33
Q

what is the prognosis for unstable angina

A
  • poor

- no exercise as treatment

34
Q

myocardial infarction

A
  • due to sufficiently long ischemic insult
  • time is tissue
  • risk increases with age
35
Q

reperfusion injury

A
  • tissue damage caused when the blood supply returns to tissue after a period of ischemia or lack of oxygen
36
Q

what is reperfusion injury associated with

A
  • microvascular injury
  • due to increased permeability of capillaries and arterioles that lead to an increase in diffusion and fluid filtration to tissues
37
Q

sudden cardiac death

A
  • natural unexpected death secondary to cardiac causes with rapid loss of consciousness
  • some cardiac issues that lead to this
  • can survive

Pathophysiology (17 decks)

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