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CVR Biweekly 2 > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

O2 supply/demand mismatch for the whole body

A

shock

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2
Q

O2 supply/demand mismatch for the heart

A

ischemic heart disease

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3
Q

common symptom of ischemia

A

angina (chest pain)

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4
Q

high-risk plaque; can rupture

A

vulnerable (unstable) plaque

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5
Q

development of blood vessels

A

angiogenesis

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6
Q

development of new blood vessels from a pre-existing vasculature

A

neoangiogenesis

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7
Q

why does tachycardia produce ischemia (why intense workout can elicit MI)

A

diastole shortens

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8
Q

ischemic heart disease (IHD) aka

A

coronary artery disease (CAD)

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9
Q

3 main types of IHD/CAD

A
  1. vasospastic
  2. stable (chronic)
  3. thromboembolic
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10
Q

type of IHD/CAD very prone to rupture

A

thromboembolic

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11
Q

type of IHD/CAD not likely to rupture

A

stable IHD (stable angina)

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12
Q

another name for vasospastic IHD

A

Variant angina

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13
Q

spastic coronary artery restricts flow and decreases O2 supply=

A

ischemia; Supply Angina

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14
Q

during exercise, stenotic coronary artery can’t meet O2 demand=

A

ischemia; Demand Angina

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15
Q

thrombus/thromboembolism occludes coronary flow=

A

ischemia; Acute Coronary Syndromes (ACS)

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16
Q

thromboembolic occlusion of coronary flow can lead to what 4 things

A

unstable angina
NSTEMI
STEMI
sudden cardiac death

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17
Q

type of angina due to vasoconstriction “Supply angina”

A

Prinzmetal (variant) angina

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18
Q

type of angina due to increased cardiac workload “Demand angina”

A

stable angina

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19
Q

leading cause of death nationally and internationally

A

Ischemic Heart Disease/Coronary Artery Disease

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20
Q

most common etiology of IHD

A

atherosclerotic obstruction

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21
Q

4 other non-atherosclerotc obstruction leading to IHD

A

myocardial bridging
microvascular angina
Prinzmetal
radiation-induced

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22
Q

coronary artery prematurely enters myocardium

A

myocardial bridging

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23
Q

total occlusion in the absence of collaterals </= 20 min

A

reversible damage

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24
Q

total occlusion in the absence of collaterals > 20 min

A

permanent damage

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25
Q

3 main ECG findings with ischemia

A

T inversion
ST elevation
ST depression

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26
Q

discomfort location of angina/MI patient

A

retrosternal pain

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27
Q

radiation of angina where

A

interscapular, arm

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28
Q

epigastric location of angina seen in

A

elderly and women

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29
Q

retrosternal _____ caused by myocardial ischemia due to stenosis or spasm of coronary arteries

A

discomfort

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30
Q

4 cardinal clinical features of angina discomfort

A

character
site/radiation
provocation factors
duration

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31
Q

lasts b/t 2-5 min

A

angina

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32
Q

provoked by exertion/stress

A

angina

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33
Q

relieved by rest/nitroglycerin

A

angina

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34
Q

clenched fist over the sternum (sign of angina)

A

Levine’s sign

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35
Q

does not radiate to trapezius m. unlike in pericarditis

A

angina

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36
Q

3 main provocation factors for angina

A

exertion
emotion
rest

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37
Q

2-3 min of discomfort

A

Prinzmetal angina

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38
Q

stable angina duration

A

2-5 min

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39
Q

unstable angina duration (thromboembolic)

40
Q

chest discomfort for 20-29 min at rest or at night

41
Q

chest discomfort for >/=30 min at rest or night

42
Q

dyspnea, nausea, fatigue, and faintness

A

Anginal equivalents

43
Q

symptoms of myocardial ischemia other than angina

A

Anginal equivalents

44
Q

Angina or Not angina: sharp/fleeting pain/dull, prolonged ache in L submammary area

A

not angina

45
Q

3 main labs that will show risk factors for CAD/IHD

A

dyslipidemia
blood glucose
CRP

46
Q

vasoconstriction w/ dynamic coronary stenosis (Supply angina)

A

Prinzmetal (variant) anginawhat

47
Q

transient ST elevation seen in what type of angina

A

Prinzmetal angina

48
Q

patients experiencing prinzmetal angina may also have other vasospastic disorders such as

A

Migraine, Raynaud’s

49
Q
A

Prinzmetal angina

50
Q

both vasoconstriction and increased cardiac workload lead to this angina (but mostly “demand” angina)

A

Stable angina

51
Q

2-5 min discomfort; exertional, predictable timing

A

Stable angina

52
Q

T inversion and ST depression seen with this angina

A

Stable Angina

53
Q
A

Stable Angina

54
Q

ST depression is suggestive of what

A

Coronary Artery Disease

55
Q

how does stress test help identify CAD

A

vascular (coronary) steal syndrome

56
Q

explain vascular steal syndrome

A

artery w/ plaque is max dilated, on exertion, blood is stolen by other arteries; artery w/ plaque robbed of it’s blood flow and O2

57
Q

due to thromboembolic occlusion (2 names)

A

Acute Coronary Syndrome (ACS); unstable angina

58
Q

rupture; unpredictable timing; 5-10 min discomfort

A

Unstable angina

59
Q

this angina experiences ST depression

A

Unstable angina

60
Q

unpredictable timing, plaque rupture; 20-29 min pain/discomfort; ST depression; necrosis

61
Q

severe angina, ST elevation; >/=30 min pain/discomfort; myocardial wall dies w/in 12-24 hrs

62
Q

heaviness of chest/pressure; 20-29 min or >/=30 min attack; unrelieved by rest or nitroglycerin

A

Myocardial Infarction

63
Q

symptoms of this include: sob, sweating, weakness, nausea, vomiting, chest pressure

A

myocardial infarction

64
Q

S wave in lead I, Q wave present and inverted T wave in lead III pattern sign of

A

pulmonary embolism

65
Q

chest pain is often not present w/ what condition (99% not diagnosed)

A

pulmonary embolism

66
Q

no Q wave seen most of the time in what

67
Q

exacerbated by vigorous exercise, experiences substernal chest PAIN

68
Q

presents w/ sweating, nausea, vomiting, sense of impending doom

69
Q

confusion, profound weakness, and hypotension

70
Q

anxious and restless; moving around; pain for >/=30 min + diaphoresis (sweating)

71
Q

what to order to diagnose STEMI

A

ECG and cardiac imaging

72
Q
73
Q

ST elevation in leads II, III, aVF

A

acute inferior MI

74
Q

ST elevation in leads (V1-V6)

A

acute anterior MI

75
Q

ST elevation specifically seen in V4 and V5

A

Acute RV MI

76
Q

preload dependent; so do NOT give nitroglycerin in this case b/c would precipitate hypotension

A

acute RV MI

77
Q

ST elevation in V1-V3

A

acute posterior MI

78
Q

cardiac biomarkers for cell death

A

Troponin I
myoglobin
CK-MB

79
Q

cardiac biomarkers for inflammation

80
Q

risk factor cardiac biomarkers

A

LDL, HDL, TG’s
lipoprotein A

81
Q

myoglobin elevated

A

cell death from MI within hours

82
Q

troponin I elevated

A

cell death from MI within 1-2 days

83
Q

CK-MB elevated

A

cell death from MI w/in a day

84
Q

what biomarker to determine re-infarction

85
Q

CK-MB is marker for what structure

A

myocardium

86
Q

what can cardiac imaging show

A

perfusion defect

87
Q

shows depolarization of interventricular septum; if present in V1-V3=

A

Q wave; injury to myocardium

88
Q

autoimmune post-infarction syndrome that presents with fever and leukocytosis

A

Dressler Syndrome

89
Q

Rx Dressler Syndrome

90
Q

heart not responding after MI, but resolves within 24 hours

91
Q

heart takes up to 7 days to recover from MI

A

hibernation

92
Q

in obstruction, coronary channels open and develop into real arterioles due to blood flow creating pressure

A

arteriogenesis

93
Q

body makes and degrades this through ubiquitin/proteosome degradation

94
Q

no oxygen w/ ischemia, HIF-1a will bind what and end up producing VEGF

A

HIF-1a binds HIF-1b

95
Q

exercise does not improve _____ in humans

A

coronary collaterals

CVR Biweekly 2 (15 decks)

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