Ischemic Heart Disease Flashcards
define ischemia
a condition in which the blood flow (and thus oxygen) is restricted or reduced in a part of the body
define hypoxemia
low oxygen content in the blood
low O2 saturation
define hypoxia
a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level
what is ACS (acute coronary syndrome)?
an umbrella term for a range of symptoms associated with sudden, reduced blood flow to the heart (i.e. cardiac ischemia)
what conditions are included in ACS?
- Heart attack (MI)
- unstable angina
- ST segment elevation MI (STEMI)
- Non-ST segement elevation MI (NSTEMI)
the diagnosis of ACS is based on what?
- pt hx: chest or left arm pain, hx of CAD
- examination:
- hypotension, diaphoresis
- pulmonary edema, rales
- ECG changes: ST-segment deviation
- elevated cardiac biomarkers
Ischemic Heart Disease (IHD) if also referred to as what?
coronary heart disease (CHD)
coronary artery disease (CAD),
athersclerotic heart disease (ASHD)
IHD includes what disorders/conditions?
- heart attacks
- angina: stable and unstable
- heart failures and arrhythmias
what are some causes of IHD
- atherosclerosis of coronary arteries (most common)
- coronary thombus or emboli
- coronary spasm
- complications of CT disorders
risk factors for IHD include:
- Age
- Gender
- Smoking Hx
- physical inactivity
- hypercholestermia
- high levels of stress
- family history
- poor diet
- HTN
- diabetes
- obesity
list common symptoms of IHD
- chest pain or discomfort, which may involve pressure, tightness or fullness
- pain or discomfort in one or both arms, the jaw, neck, back, or stomach
- SOB
- feeling dizzy or lightheaded
- nausea
- sweating
how is IHD diagnosed?
- blood testing:
- cardiac enzymes
- CRP
- homocysteine
- abnormal lipid profile
- BNP
- prothrombin
- ECG alteration
what is ischemic cardiomyopathy?
most common cause of dilated cardiomyopathy
caused by CAD which causes an insufficient blood suppy to the heart resulting in myocyte ischemia
heart changes geometric shape in response to chronic shortage of O2
T/F: ppl can live with CAD for a long time
TRUE
Ischemic cardiomyopathy results in damage that can lead to ________
cardiac remodeling
give an example of cardiac remodeling that can occur from Ischemic cardiomyopathy
- myocardial fibrosis
- arrthymias
- possible cardiac conduction system impairments
- cell death
- left ventricular enlargement and dilation
ultimately ischemic cardiomyopathy patients develop _____________
congestive heart failure
what are the two types of angina pectoris?
stable and unstable
IHD angina can lead to what?
- Myocardial infarction
- sudden cardiac death
- ischemic cardiomyopathy
define angina pectoris
intermittent chest pain caused by transient BUT reversible myocardial ischemia
describe stable angina?
- caused by a mismatch between O2 delivery and O2 need
- brought on by exertion or other forms of stress
- occurs at a predictable HR
- crushing or squeezing substernal sensation w/possible radiation
- reduction in stress reduces symptoms
how is stable angina treated?
nitroglycerin
describe unstable angina
- brought on by exertion or other form of stress
- onset is unpredictable
- crushing or squeezing substernal sensation with possible radiation to the arm
what is the main difference between stable and unstable angina?
unstable has an unpredictable onset
what is thought to be the cause of unstable angina?
thought to occur because of acute plaque changes, and/or coronary artery vasospasm
how is an MI an ischemic heart disease?
if ischemic insult is sufficiently long, tissue damage and death results
what is a reperfusion injury?
tissue damage caused when blood supply returns to tissue after a period of ischemia or lack of oxygen
associated with microvascular injury, particularly due to increased permeability of capillaries and arterioles that lead to an increased diffusion and fluid filtration into the tissues
what is sudden cardiac death?
natural unexpected death secondary to cardiac causes with rapid loss of consciousness
____% of CAD deaths are from sudden cardiac disease
50%
list some anatomic findings in individuals who suffered sudden cardiac death
- acute coronary plaque rupture or thrombosis
- clinically quiet MI (minority of cases)
- No acute lesion but >60% stenosis of a coronary artery, often LAD
