Ischemic Heart Disease Flashcards
What is the main cause of the ischemias
Atherosclerotic plaques
What is part of the acute coronary syndrome
Unstable angina
STEMI
NSTEMI
What wid be seen in the stable angina
Normal ecg
Normal bio markers
Subendocardial ischemia (demand ischemia)
What would be the unstable angina
Ruptured plaque
ST depression and the T inversion
Normal bio markers
What would be seen in the STEMI
ST elevation and hyper acute T waves
Damage to the tissue/cells, troponin would be elevated
Trans mural infarct
What would be seen in the NSTEMI
ST depression and t-wave inversion
Troponin elevated
Subendocardial infArct
What are the bio markers used
Troponin
Myoglobins
CK-MB
What markers would show the reoccurring infarct and what would not
The CK-MB as would go back to normal fast
Troponin not as would remain high for many days
What would the myoglobins show
The immediate infarct
Not specific to the heart muscle however
What else can be used to show the infarct
ECG
Cardiac catheter (Percutaneous coronary intervention) or the fibrolytic therapy
What are the normal symptoms of ischemic chest pain
Dull and crushing pain, not sharp
Elevated with rest
Provoked with exercise and activity
Nausea and sweating
What would be the features of a right ventricle MI
jugular venous distension (blood would back flow to the jugular vein)
Hypertension
Clear lungs
Bradycardia
Edema (lower extremities)
What would be the features of the left ventricle MI
Hypotension
Reflex tachycardia
Pulmonary edema (as blood backflows and fluid is more able to leave)
S4 Heart sound
What is the S4 sound heard with the LV MI
Atrial gallop
Happens in diastole
Blood would try to flow to the LV but would be stiff due to the infarct
What would be the features of the pericarditis
Inflammation of the pericardial layers
Frictional rub of the layers
Sharp and localised chest pain
Cone shaped ST elevation (not round like normal)
Happens 24hrs to 3days after
What happens 3-14 days after the MI
Rupture syndrome
Fibrosis of the tissue
Rupture of the ventricular septum
Ruptured papillary muscles (so would not be able to have the proper closing of the valves, mitral regurgitation)
What wall would be effected when have the ST elevation of the V1,2 and 3 leads
The anterior wall
What area is effected when have ST elevation of the lead 2,3 and the aVF
The inferior wall
What area would be effected when have the ST elevation in lead 1 and aVL
The lateral wall
What is the TIMI score
Would show the risk of the MI
High - need the catheter
Low - medical attention
What is the stress test
Do activity or exercise or can give drugs that would increase the heart activity
Shows the likelihood of the MI
High - cardiac Cather
Low - medial intervention
What is the cardiac catheterisation
Catheter through the radial or the femoral artery’s
Goes to the aorta and then can go to the coronary artery
Release a dye, can see which vessels occluded
When would you not do the catheter and do the fibrosis therapy
When the person is allergic or unable to have the dye or the Cather pass through the body
What is fibrolytic therapy
Lysis of the clots
Stops the occlusion
