Ischemic Heart Disease Flashcards
What is an inadequate supply of blood to the heart, caused by a partial or total bloackage of a coronary artery.
Ischemia
What are the three stages that the myocardium undergoes when a coronary artery becomes occluded?
Ischemia, Injury, and Infarction
Myocardial cell injury (damage) occurs when the ischemic process is ______
More severe
What is necrosis or death of myocardial cells known as?
Infarction
What is the leading cause of death in the US?
MI
What begins as a fatty streak, builds fibrous plaque, and then becomes a complicated lesion that can completely block off an artery?
Atherosclerosis
What is due to a spasm that causes a temporary obstruction to coronary artery blood flow? Causes include cocaine use.
Coronary Artery Spasm
What is typically the result of the sudden formation of a clot or a piece of plaque that breaks off and blocks a coronary artery?
Coronary Artery Thrombosis
What are the causes of ischemic heart disease?
Atherosclerosis, coronary artery spasm, coronary artery thrombosis, decreased coronary blood flow, increased myocardial workload, or congenital anamolies.
What are some causes of decreased coronary blood flow?
Arrythmias, pulmonary embolism, hypotension, or shock.
What is chest pain due to myocardial ischemia?
Angina Pectoris
Which type of angina is effort-induced chest pain,lasts seconds to minutes, and is relieved by rest or nitroglycerin (NTG).
Stable angina pectoris
Which type of angina tends to last longer, occurs more frequently, is not necessarily due to effort, and may be relieved temporarily by NTG?
Unstable angina pectoris
Which type of angina occurs at rest, early hours of the morning, is often associated with ST segment elevation on the EKG, and is thought to be due to coronary artery spasm?
Variant Angina
What type of angina is also known as Prinzmetal’s angina?
Variant Angina
What may cause detection of a new murmur post MI?
Ischemic mitral regurgitation due to LVD, arrythmias, or papillary muscle ischemia/infarct/rupture.
What does the acronym MONA stand for?
morphine, oxygen, nitroglycerin, and aspirin.
What does coronary artery bypass graft surgery do?
CABG creates new routes around narrowed and blocked arteries.
According the WHO what are the 3 criteria for an MI?
- History of severe, prolonged chest pain.
- Unequivocal EKG changes to incude abnormal persistent Q waves.
- Changes in serial cardiac biomarker levels that indicate myocardial injury and infarction.
Which serum cardiac biomarker rises 3-5 hours after an MI and remains elevated up to 21 days?
Troponin T
Creatine kinase (CK), phosphokinase (CPK), and CK-MB ( the muscle type) are all enzymes that are released with ______
tissue necrosis
What is an inflammatory process involving the parietal and visceral layers of the pericardium that may lead to a pericardial effusion?
Pericarditis
What is a collection of fluid within the pericardial space?
Pericardial effusion
Between what two layers does a pericardial effusion occur?
The parietal and visceral layers of the pericardium
What is a common response to an acute MI?
pericardial effusion
What is a post MI illness that presents with fever, pericarditis, pericardial effusion, and pleuritis?
Dressler’s Syndrome
may present weeks to months after an MI
What would cause a bulge in the left ventricular wall that persists during diastole and systole with akinesis ir dyskinesis?
LV true aneurysm
A “hinge point” where good myocardium meets bad myocardium usually persists.
What is a narrow perforation of the left ventricular free wall with a false chamber?
A left ventricular pseudo-aneurysm
Usually has a saccular or globular contour.
Where is a left ventricular thrombus most commonly located?
At the apex
What is a rupture of the interventricular septum that creates a shunt between the ventricles?
VSD
What type of infarction is papillary muscle dysfunction most often associated with?
Inferior MI
Isolated right ventricular infarction is ______
Rare
Right ventricular infarction is most often associated with an ______
Inferior MI
On 2-D echo what is seen in areas of ischemia or infarct?
WMA
Why do resting echos tend to miss ischemic heart disease?
At rest the heart may prefuse adequately; therefore a stress echo should be performed.
What are the risk factors for ischemic heart disease?
Advancing age, family hx, diabetes, smoking, HTN, high cholesterol, obesity, sedentary lifestyle, stress, and over consumption of alcohol.
In regards to advancing age what groups are especially high risk for developing ischemic heart disease?
Males and post-menopausal women
What are the diagnostic test used for ischemic heart disease?
Cariac cath, stress echo, nuclear stress, and 12 lead EKG
