Ischemic Heart Disease Flashcards
Where does the heart receive its blood supply from?
L+R coronary arteries
Where do the coronary arteries arise from?
sinus of valsalva behind R+L cusps of AoV
When does the myocardium receive its blood?
diastole
Systole or Diastole: AV opens, cusps cover sinuses
systole
Systole or Diastole: after closure of AV, blood flows backwards briefly filling sinuses
diastole
What artery originates in the upper portion of the left sinus above left coronary cusp?
Left coronary artery
What does the left coronary artery bifurcate into?
left anterior descending and left circumflex branch
What does the left anterior descending artery supply?
anterior LV freewall, anterior IVS, apical septum and apex
What does the left circumflex artery supply?
posterior LV, LA, lateral wall of LV
What artery originates on the anterior basal portion of the RV then wraps around the RV lateral and posterior portion?
right coronary artery
What does the right coronary artery branch into?
acute marginal artery and posterior descending artery
What does the acute marginal artery supply?
RV
What does the posterior descending artery supply?
inferior portion of heart
How much of the population has a ‘right dominant’ coronary artery system?
90%
What does it mean to have a ‘right dominate’ coronary artery system?
RCA supplies the inferior portion of the heart
How much of the population has a ‘left dominant’ coronary artery system?
10%
What does it mean to have a ‘left dominant’ coronary artery system?
LCx supplies the inferior portion of the heart
What must happen in order for the heart to function?
the supple of oxygenated blood to the heart must equal the demand from the body
What happens when there is a blockage in the coronary arteries?
MI
What causes ischemia to occur?
narrowing in coronary arteries and demand of blood exceeds supply
What involves the development of ischemia and death of tissue?
MI
What is necrosis?
tissue death
T/F: MI damage is reversible
False
What is the leading cause of death in the US?
MI
What is the most common cause of IHD?
atherosclerosis
What are the other causes of IHD?
coronary artery spasm, embolus, plaque, blood clot, congenital coronary anomalies
What is the build up of plaque in the lining of the coronary arteries called?
atherosclerosis
What causes temporary loss of blood flow in the coronary arteries?
coronary artery spasm
What are the types of angina?
variant, stable, unstable
What are the signs and symptoms of IHD?
angina, sudden cardiac death, murmur OR no symptoms
What type of angina occurs at rest and is associated with coronary artery spasm?
variant
What type of angina lasts longer but occurs more frequently?
unstable
What type of angina is effort induced and is relieved with rest?
stable
What could be a cause of a new murmur post MI?
papillary muscle ischemia, infarction, rupture, LV dilatation, dysrythmias, VSD
What are the diagnostic tests used for IHD?
cardiac catheterization, EKG stress test, stress echo, nuclear testing
What is the gold standard for IHD testing?
cardiac catheterization
What is the invasive method providing presence, location, and severity of blocking for IHD?
cardiac catheterization
What is an EKG evaluation during exercise called?
EKG stress test
What provides images of the functional response of the heart to exercise by detecting wall motion abnormalities?
stress echo
What determines the perfusion of blood to the myocardium by utilizing a radioactive tracer?
nuclear testing
What occurs when a blood clot suddenly forms within a coronary artery, usually due to the acute rupture of plaque?
acute coronary sydrome
T/F: ACS is a medical emergency
true
What is it called when the coronary artery is completely blocked off by a blood clot and all of the heart muscle starts to die?
STEMI
What is the most severe type of MI?
STEMI
What does the EKG for a STEMI look like?
has an elevated baseline
What is identical to unstable angina except the cardiac enzyme blood tests are abnormal?
NSTEMI
Wha does an EKG for NSTEMI look like?
depressed baseline
What does an abnormal cardiac enzyme blood test indicate?
cell damage to heart muscle cells
What is it called when the wall motion is greater then normal?
hyperkinesis
What is it called when the wall motion is less than normal?
hypokinesis
What is it called when the heart is without wall motion?
akinesis
What is it called when the wall motion is in the opposite direction?
dyskinesia
What are the complications of IHD?
pericardial effusion, dressler’s syndrome, mural thrombus, LV aneurysm, myocardium/IVS rupture, papillary muscle dysfunction
What is the collection of fluid within the pericardial space?
pericardial effusion
What is a post MI illness that presents with fever, pericarditis, pericardial effusion, and plueritis?
dressler’s syndrome
When does dressler’s syndrome occur?
2-3 weeks or months after MI
What is most commonly located in the LV apex?
mural thrombus
What is most commonly detected within the first 24-48 hours?
mural thrombus
What is a bulge in the LV wall?
LV aneurysm
