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Cardiovascular > ischemic heart disease > Flashcards

ischemic heart disease Flashcards

1
Q

Treatable risk factors for CAD

A

smoking
hypertension
Dyslipidemia/cholesterol

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2
Q

Treatable questionable risk factors for CAD:

A 
diabetes
obesity
inflammation
psychological stress
sedentary lifestyle
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3
Q

Not treatable risk factor for CAD

A

male gender
age
genetics

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4
Q

Smoking causes a ______ tendency, promotes _____ by aryl hydrocarbon

A

thrombogenic

atherosclerosis

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5
Q

Smoking causes adverse effect on ____, ___ decrease O2 delivery, and causes ___dysfunction

A

lipoproteins (decrease DHL)
CO
Endothelial

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6
Q

HTN increases shear stress on arterial wall that cause direct ____

A

endothelial cell injury

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7
Q

HTN: Increased arterial wall stress initiates pathologic cell signaling program causing ____

A

oxidant stress, cellular proliferation

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8
Q

Diabetes and insulin resistance are associated with ________

A

inflammation, oxidative stress, dyslipidemia that predispose to atherosclerosis.

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9
Q

dyslipidemic triad includes ___

A

high LDL
low HDL
high Triglycerides

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10
Q

Oxided LDL becomes ___

A

pro inflammatory/atherogenic

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11
Q

Oxidized LDL effects:(4)

A
  1. injure vascular endothelium = impaired endothelial function
  2. Deposite in arterial wall = plaque volume/foam cell
  3. Activate inflammatory cell = progression/instability of lesion
  4. Activates platelet/prothrombotic
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12
Q

Roles of HDL (5)

A
  1. inhibit LDL oxidation
  2. Inhibit TF
  3. Enchance reverse cholesterol transport
  4. Stimulate endothelial NO production
  5. Inhibit endothelial adhesion molecules
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13
Q

DHL Overall function is to oppose ____

A

atherothrombosis

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14
Q

Inflammation plays a key role in ___ and ___

A

initiation and progression of atherosclerosis

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15
Q

Lipid laden macrophages in arterial walls are highly ____

A

pro-inflammatory

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16
Q

Extravascular inflammation (ex: ____) increase risk of _____ ____events

A

dental diseases

atherosclerotic CV events

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17
Q

Circulating markers of inflammation provides _____ about CV ___; ie: ___ (which is released by liver upon ___signal)

A

info
risk
C-reactive protein
IL6

18
Q

stable CAD causes _____

A

myocardial ischemia

19
Q

myocardial ischemia is:

A

tissue blood flow insufficient to meet oxygen requirement

20
Q

Cardinal symptoms of myocardial ischemia is ___

A

chest pain/agina pectoris

21
Q

coronary circulation is unique in ___ metabolism for energy supply, extract ___% of O2, perfused during ____

A

aerobic
near 100%
diastole ony

22
Q

If O2 demands increase, supply will increase by ___ in heart

A

increase blood flow

23
Q

Myocardial O2 supply determined by:

A

Coronary blood flow rate

Oxygen content of blood

24
Q

Coronary blood flow rate determined by (4)

A
  1. perfusion pressure
  2. perfusion time
  3. vascular resistance
25
Q

Autoregulation range implies

A

heart will provide constant coronary flow within moderate change in perfusion pressure

26
Q

_____ can compromise coronary flow by intramural coronary vessel compression

A

tachycardia

27
Q

O2 supply compromised by:

A

anemia (less hemoglobin)

Hypoxemia (incomplete O2 sat)

28
Q

Treatment of:

  1. perfusion pressure
  2. Diastolic time
  3. Coronary resistance
  4. O2 content
A
  1. prevent HTN
  2. rate control drugs
  3. Vasodilator/coronary agnioplasy/bypass surgery
  4. treat anemia/hypoxemia
29
Q

Determinants of Mycoardial O2 demand

A
  1. heart rate
  2. wall tension
  3. inotropic state
30
Q

Treatment of:

  1. systolic pressure
  2. HR
  3. Wall tension
  4. Inotropic state
A
  1. antihypertensive drug
  2. rate slowing drug
  3. limit LV - diuretic/nitrate
  4. negative inotropes (beta/Ca blocker)
31
Q

stable CAD caused by:

A

obstructive coronary lesion limits coronary flow

32
Q

Causes of unstable CAD (8)

A 
inflammation
weakening fibromuscular cap
plaque fissue/rupture
thrombogenic component to blood
Thrombosis partial/complete vessel occlusion
MI
Cardiac dysfcn
33
Q

unstable angina is caused by a ______ occlusion of vessel that ____ heart attack with biomarkers ___

A

near complete
threatened
negative

34
Q

Acute MI is a ___ CAD

A

unstable

35
Q

AMI is caused by ______ coronary flow reduction, thrombus with ___vessle occlusion, wavefront with ______, biomakers ____

A

persistent/severe
complete
myocardial necrosis
elevated

36
Q

AMI ______ is key to treatment but can also cause ___ injury

A

early reperfusion

reperfusion

37
Q

AMI high early mortality ___; late mortality ___

A

1/3 pt don’t get to hospital

Extent of LV dysfunction

38
Q

Timeline of acute MI

A
  1. diastolic dysfunction
  2. systolic dysfunction
  3. ECG sign of M. injury
  4. symptoms
    hour:
    mycardial necrosis/infarction
39
Q

time: ____ = no harm; ____ 50% infarct

A

0-30 min
2 hours
3-4 hr = near complete necorsis

40
Q

inflamed arterial atheroma releases ___ markers (ie ___; downstream myocardial injury shows ___ markers (ie__)

A

Inflammatory (markers)
CRP
cardiac (markers)
Troponin/creatine kinase

Cardiovascular (11 decks)

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