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Ischemic Heart Disease > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

What are 3 etiologies of Ischemic heart disease?

A
  • CAD -atherosclerosis
    -congenital coronary anomalies
    -coronary artery spasm
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2
Q

The size of an aneurysm during systole?

A

Increases

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3
Q

What’s the pathophysiology of ischemic heart disease?

A
  • atherosclerotic plaque causes stenosis in coronary arteries
  • this obstructs blood flow
  • leads to deprivation of myocardial o2 = ischemia
  • total blockage causes muscle death = ischemia
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4
Q

What are risk factors for ischemic heart disease ?

A
  • sex
    -age
    -diabetes
    -hyperlipidedma
  • obesity
    -family history
    -smoking
    -HTN
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5
Q

What are complications of ischemic heart disease?

A
  • Aneurysm
    -arrhythmias
    -mural thrombus
    -pap muscle rupture
    -VSD
    -death
    -Pseudoaneurysm
  • PE
    -pap muscle dysfunction
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6
Q

How common are aneurysms with ischemic heart disease?

A

8-15%

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7
Q

How common are arrhythmias with ischemic heart disease?

A

90%

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8
Q

___ thrombus occurs with ____ MI ___ to ___ % of the time

A

Mural ; acute ; 20-40%

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9
Q

Papillary muscle rupture occurs in __% of MI’s

A

1%

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10
Q

Papillary muscle rupture causes death in __% of MI’s patient

A

5%

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11
Q

Papillary muscle rupture occurs in 90% of ____ MI’s

A

Inferior

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12
Q

___% of patients are dead in 8 weeks due to pap muscle rupture

A

98

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13
Q

VSD’s occur in ___% of MI patients

A

2

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14
Q

What is the most common mechanical complication of an MI?

A

Aneurysm

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15
Q

What’s the difference between mural vs. transmural thrombus ?

A

Mural is attached partial section of wall
Transmural takes up entirely of wall

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16
Q

What’s another name for mural thrombus?

A

Subendocardical

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17
Q

A new murmur post MI can be due to what 4 things?

A
  • MR
    -ischemic VSD
    -pap muscle rupture
    Pap muscle dysfunction
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18
Q

A physical sign of ischemic heart disease is ___

A

Angina

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19
Q

__% of MI’s are silent

A

25%

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20
Q

Severe acute MR patients often present with?

A

Florid pulmonary edema

21
Q

What’s the difference between stable and unstable angina ?

A

Stable follows a pattern of excertion causing chest pain

Unstable doesn’t follow a pattern. Chest pain occurs without excertion and is more dangerous and indicative of a MI

22
Q

What’s a flail leaflet?

A

Abnormality of leaflet mobility. Due to chordal rupture or dissociation

23
Q

Flail leaflet is associated with what disease?

A

MVP

24
Q

What type of MI causes pap muscle rupture?

A

Inferior MI

25
Q

What are 7 echo signs of ischemic heart disease?

A

-RWMA
-LV dilation with ischemic cardiomyopathy
- Thrombus in akinetic or dyskinetic areas
-pap muscle dysfunction
-pap muscle Rupture ( VSD or pesudeoanureysm)
- dresser syndrome with PE
-ventricular aneurysm

26
Q

A true aneurysm has what 3 characteristics?

A

-wide base
-low risk of free rupture
- encases the myocardial layer ( or all 3 layers of the heart)

27
Q

A pseudoaneurysm has what 4 characteristics?

A

-narrow base
-high risk of free rupture
- walls composed of thrombus
-has only 1-2 layers of the heart not all 3

28
Q

The most common location for a pseudorandom is?

A

Inferior basal

29
Q

What information do you need pre-op in a patient with a LV aneurysm?

  1. Size
  2. Location
  3. Thrombus?
  4. Movement of other walls
A

4

30
Q

Color Doppler in ischemic disease can be good for ?

  1. MR
  2. TR
  3. AR
  4. VSD
  5. ASD
A

4.

31
Q

What may be seen secondary to a pap muscle dysfunction on echo?

A

MR

32
Q

If a ischemic VSD is present what direction will the shunt be?

A

L-R

33
Q

What is Kawasaki disease?

A

Inflammation of small to medium sized vessels

34
Q

What do you look for in a patient with Kawasaki disease?

A

Coronary artery aneurysms

35
Q

Who is most affected by Kawasaki disease?

A

Children usually 5 years and younger

36
Q

What are other symptoms of Kawasaki disease?

A

-fever
-enlarged lymph nodes
-a rash in genital area, lips, palms, soles of feet
-red eyes

37
Q

Hypokinesiss means?

A

Less motion than normal

38
Q

Dyskinesiss means ?

A

Motion is opposite than normal direction

39
Q

How many segments of a wall need to be affected before calling it a RWMA?

A

1 segment

40
Q

What is the IVS motion in a patient with a a LBBB?

A

Dyskinetic or paradoxical

41
Q

Another word for dyskinetic is?

A

Paradoxical

42
Q

What type of aneurysm gives a fusiform
shape?

A

True aneurysm

43
Q

What kind of aneurysm gives a saccular shape?

A

Pseudaneurysm

44
Q

What are two signs on Doppler of a ischemic heart disease?

A
  • MR due to secondary pap muscle rupture
    -L-R VSD shunt
45
Q

Which coronary artery supplies, the atrial septum?

A

RCA

46
Q

Which coronary artery supplies, the SA and AV nodes?

A

RCA

47
Q

What is meant by right dominance?

A

When the right cornary artery gives rise to the posterior descending artery 85% of the time 

48
Q

What percentage of people are right dominant?

A

85%

49
Q

What is the medication used with a nuclear stress test?

A

Thallium

Ischemic Heart Disease (2 decks)

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