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Cardiopulmonary pathology > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

What arteries are the major supply blood to the heart?

A

coronary arteries

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2
Q

What is ischemic heart disease?

A

the imbalance of myocardial oxygen btw supply and demand

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3
Q

What are the causes of ischemic heart disease?

A

atherosclerosis of coronary arteries

hypotension

severe anemia

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4
Q

Why does atherosclerosis of coronary arteries lead to ischemic?

A

because it decreases the blood flow around the heart

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5
Q

How does atherosclerosis of coronary arteries decrease blood flow?

A

increase the resistance to flow

platelet aggregation -> more narrowing arteries

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6
Q

How many % of proximal narrowing vessel can be compensated by distal dilation?

What % ___ cant be compensated? What will resutl?

A

60%

>70%

ischemic heart disease

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7
Q

What will result when endothelial dysfunction occur?

A

platelet aggregations and inappropriate constriction of coronary arteries occur

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8
Q

myocardial hypoxia

A

ATP decreases

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9
Q

What are the consequences of ischemic heart disease?

A

myocardial hypoxia

accumulation of waste products

necrosis of myocardial tissues

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10
Q

dypsnea

A

shortness/ difficulty of breathing

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11
Q

pulmonary congestion

A

the accumulation of blood in the lung

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12
Q

arrhythmias

A

irregular heart beat

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13
Q

what does high pressure in left atrium & pulmonary veins will cause?

A

pulmonary congestion & dypsnea

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14
Q

what are the waste metabolites accumulated in the heart if ischemic heart disease occur ?

A

serotonin, ADP & lactate

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15
Q

What does accumulation of waste products will cause with ischemic heart disease?

A

angina & arrhythmias

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16
Q

What does myocardial hypoxia cause?

A

reduction of ventricular systole & distole relaxation

higher diastolic pressure in left atrium & pulmonary veins

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17
Q

What are myocardial oxygen supply dependent on?

A

oxygen content of blood (constant)

coronary blood flow (manageable)

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18
Q

aortic regurgitation

what is the consequence of this?

A

the heart valve diseases that keep the aortic valve from completely closing

reverse blood flow from aorta to left ventricle

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19
Q

what will affect the oxygen content of blood?

A

the amount of Hb concentration & degree of systematic oxygenation

20
Q

What will influence the coronary flow?

A

perfusion pressure

local metabolites

coronary vascular resistance

21
Q

perfusion pressure

What will reduce this pressure?

A

aortic diastolic pressure

hypotension & aortic regurgitation

22
Q

What factor will influence the coronary vascular resistance?

A

the intrinsic coronary tone & the physically impact on coronary arteries

23
Q

What determine the increase extraction of oxygen from coronary blood flow?

A

vasodilator vs vasoconstrictor

24
Q

what are the metabolic factors that vasodilators?

A

ADP, H+, CO2 & lactate

25
Q

What are the endothelial cells vasodilator? endothelial cells vasoconstrictor?

A

NO, prostacyclin & EDHF

Endothelin I

26
Q

What are the neural vasodilator of coronary vessels? neural vasoconstrictor?

A

alpha-adrenergic receptor

beta- adrenergic receptor

27
Q

What is the myocardial oxygen demand dependent on?

A

ventricular wall stress

HR

contractility

28
Q

Why does the HR increase require more oxygen?

A

because the heart require more ATP

29
Q

What chemical increase the contractility of the heart?

A

Catecholamine

30
Q

ventricular wall stress

what is its relationship with oxygen consumption?

A

the intraventricular pressure divided by the thickness of the wall

the more wall stress, the more oxygen is needed

31
Q

when can the intraventricular pressure increase?

A

when there is hypertension or aortic stenosis

32
Q

intraventricular pressure

A

the blood pressure within the heart’s ventricles

33
Q

What happen to the thickness of ventricular wall when it hypertrophy?

What does this mean to the wall stress? To oxygen demand?

A

the wall getting thicker

reduce the wall stress

oxygen demand decrease

34
Q

What will result in the ventricular wall hypertrophy?

A

increase ventricular filling (EDV increases)

35
Q

coronary perfusion pressure

A

the pressure that drives the coronary blood pressure

36
Q

What does the ECG of stable angina different from normal ECG?

A

ST segment elevates or depresses

T wave invert or become flat line

37
Q

What is the symptoms of unstable angina different from stable angina?

A

the exertional pain is more accelerated

the plagues rupture with subsequent formation of clot (thrombosis)

myocardial infarct can occur

38
Q

Do both stable & unstable angina vasoconstrict or vasodilate?

A

vasoconstrict

39
Q

What symptoms does variant angina have?

A

intense vasospasm although there is no overt plagues

40
Q

What test can we use to diagnose the silent ischemia?

A

stressing test with ECG recording

41
Q

what is syndrome X?

A

the patients with symptom of angina without demonstrable of atherosclerosis

42
Q

What drug can we use to treat ischemic syndromes?

what is its effect?

A

sublingual nitroglycerin

relax the VSMC -> decrease venous return & oxygen demands

43
Q

coronary revascularization

Examples of some methods?

A

the methods of restoring the blood flow in coronary vessels

stent, angioplasty, coronary bypass graft

44
Q

The steps of coronary artery stent

A

stents, in its orginal collapsed state, is advanced to stenosis, on a ballon catheter

ballon is inflated -> stent expanded

ballon is deflated and catheter is removed, leaving the stent permanently in space

45
Q

What do beta-blockers drugs do?

A

decrease the HR and contractility

Cardiopulmonary pathology (12 decks)

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