Ischemic Heart Disease Flashcards
When does stable angina occur?
with exertion <20 min
when does unstable angina occur?
at rest <20 min
what is prinzmental angina ?
coronary spasm - leads to chest pain unrelated to exertion
What does an EKG show for:
- stable angina
- unstable angina
- prinzmental angina
- stable angina - ST depression
- unstable angina - ST depression
- prinzmental angina - ST elevation
What disease can cause an MI in children?
kawasaki vasculitis
What parts of the heart are affected when each of the following are infarcted:
- LAD
- RCA
- left circumflex
- anterior wall of ventricle, anterior IV septum
- posterior wall of LV, posterior IV septum
- lateral wall of LV
Troponin:
when does it rise?
when does it peak?
when does it return to normal?
- 2-4 hours
- 24 hours
- 7- 10 days
CKMB
when does it rise?
when does it peak?
when does it return to normal?
what is it useful for?
4-6 hours
peaks at 24 hours
normal at 72 hours
diagnosing reinfarction
In an infarction, what part of the heart is affected first?
endocardium (inside to out)
what is a significant finding on pathology after giving someone fibrinolysis or angioplasty for their MI?
contraction band necrosis
-rush of Ca2+ causes contraction
dense perpendicular pink fibers
Describe the appearance of the heart at 4-24 hours after an MI?
coagulative necrosis - dark
pyknosis, karorexis, karyolysis
wavy fibers - noncontractile ischemic myocytes are stretched
What is a major complication after an MI in the first 4-24 hours?
arrythmia
How does the heart appear 1-3 days after an MI?
yellow - neutrophils arrive
What is a complication 1-3 days after an MI?
fibrinous pericarditis
What cells are predominantly present 4-7 days after an MI?
macrophages
What are some complications that occur 4-7 days after an MI?
rupture of:
ventircular free wall - tamponade
IV septum - Lā>R shunt
papillary muscle
How does the heart appear 1-3 weeks after an MI?
red border emerges
What is a complication 1-3 weeks after an MI?
extension of the infarct
Months after an MI, what is the appearance, and what complication can occur?
fibrous white scar
- aneurysm
- mural thrombus
- autoimmune pericarditis - dressler syndrome
What types of patients are notorious for dying from silent MIs?
diabetics with autonomic dysfunction
cardiac transplant patients - heart is denervated
What is the definition of congestive heart failure?
high atrial filling P relative to stroke volume
What are some symptoms of Left CHF?
pulmonary edema and crackles
paraoxysmal nocturnal dyspnea and orthopnea
confusion and disorientation
fatigue and weakness
What are heart failure cells, when are they seen?
left CHF - capillaries in the lungs rupture, macros consume blood - hemosiderin laden macros
What is the most common cause of right CHF?
left CHF!!!
