Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophys > Ischemic Heart Disease > Flashcards

Ischemic Heart Disease Flashcards

1
Q

What is a condition in which the blood flow (and thus oxygen) is restricted or reduced in a part of the body?

A

Ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is hypoxemia?

A

low oxygen content in the blood (low O2 stats)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is hypoxia?

A

a condition in which the body or a region of the body is deprived of adequate oxygen supply at the tissue level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute coronary syndrome (ACS) is an umbrella term for what? What does it include?

A

a range of symptoms associated with sudden, reduced blood flow to the heart i.e. cardiac ischemia

  1. Heart attack (MI)
  2. unstable angina
  3. ST segment elevation MI (STEMI)
  4. Non-ST segment elevation myocardial infarction
  5. heart attack (NSTEMI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F Acute coronary syndrome is a diagnosis.

A

True, an event characterized by sudden reduced blood flow to heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Diagnosis of acute coronary syndrome (ACS) is based on the patient hx and examination of what?

A
  1. Patient HX: Chest or left arm pain; hx of CAD
  2. Examination:
    - Hypotension, Diaphoresis
    - Pulmonary edema, rales
    - ECG changes: ST-segment deviation
    - Elevated cardiac biomarkers including TnI, TnT, CK-MB: Tn-Troponin I & T; CK-creatine kinase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ischemic heart disease (IHD) is also referred to as what 3 things?

A
  1. Coronary heart disease (CHD)
  2. coronary artery disease (CAD) - plaque buildup in an artery
  3. atherosclerotic heart disease (ASHD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ischemic heart disease includes what?

A
  1. Heart attack - plaque cracks and a blood clot blocks the artery
  2. Angina - stable and unstable - harder for blood to get through artery
  3. heart failure
  4. Arrhythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

T/F IHD (ischemic heart disease) is most common specific diagnosis under the umbrella term of ACS (acute coronary syndrome).

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most common cause of ischemic heart disease?

A

Atherosclerosis of the coronary arteries -

A progressive inflammatory disorder of the arterial wall characterized by localized lipid deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are other causes of ischemic heart disease?

A
  1. Coronary thrombus or emboli
  2. Coronary spasm
  3. Complications of connective tissue disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are risk factors for ischemic heart disease? (10)

A
  1. age
  2. HTN
  3. Diabetes
  4. Gender
  5. Smoking
  6. Physical inactivity, obesity
  7. Hypercholestermia/hyperlidemia
  8. High levels of stress
  9. Family history
  10. Poor diet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common symptoms of ischemic heart disease? (6)

A
  1. Chest pain or discomfort, which may involve pressure, tightness or fullness
  2. Pain or discomfort in one or both arms, the jaw, neck, back or stomach
  3. Shortness of breath
  4. Feeling dizzy or lightheaded
  5. Nausea
  6. Sweating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ischemic heart disease is diagnosed with blood tests looking for what? (6)

A
  1. Cardiac enzymes (including troponin and creatine kinase)
  2. C-reactive protein (CRP)
  3. Homocysteine
  4. Abnormal lipid profile
  5. Brain natriuretic peptide (BNP) (produced by atrium with atrial stretching)
  6. Prothrombin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is ischemic cardiomyopathy caused by?

A

Caused by CAD which causes an insufficient blood supply to the heart resulting myocyte ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most common type of dilated cardiomyopathy (change in structure geometry)?

A

ischemic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F One can live with CAD for only a short amount of time.

A

False, One can live with CAD for a long time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Constant cardiac ischemia results in what damage?

A

irreversible myocyte damage -> cardiac remodeling:

  1. Myocardial fibrosis
  2. Arrhythmias
  3. Possible cardiac conduction system impairments
  4. Cell death
  5. Left ventricular enlargement and dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Worsening CAD is a precursor of what?

A

of ischemic cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ischemic cardiomyopathy patients ultimately develop what?

A

clinical congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Prognosis of ischemic cardiomyopathy is largely determined by what?

A

myocardial viability (the number of functioning myocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Natural history/progression of atherosclerosis:

A

fatty streak -> fibrous plaque -> calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the clinical horizon of a patient with calcification atherosclerosis? (4)

A
  1. Myocardial infarct
  2. Cerebral infarct
  3. Gangrene of extremities
  4. Abdominal aortic aneurysm
24
Q

What is angina pectoris?

A
  • progressive occlusion to coronary arteries
  • Intermittent chest pain caused by transient BUT reversible myocardial ischemia
    1. Stable angina
    2. Unstable angina
25
Q

Angina pectoris can lead to what 3 things?

A
  1. Myocardial infarction
  2. Sudden cardiac death
  3. Ischemic cardiomyopathy
26
Q

What is stable angina caused by?

A
  • Caused by a mismatch between O2 delivery and O2 need

- Brought on by exertion or other form of stress

27
Q

Stable angina will occur at what HR?

A

Predictable

28
Q

What can decrease symptoms of stable angina?

A
  1. Reduction in stress reduces symptoms

2. Nitroglycerin

29
Q

CCS Functional Classification of Angina:

Class 1 -

A

Activity evoking angina - prolonged exertion

Limits to physical activity - none

30
Q

CCS Functional Classification of Angina:

Class 2-

A

Activity evoking angina - walking > 2 blocks or >1 flight of stairs
Limits to physical activity - slight

31
Q

CCS Functional Classification of Angina:

Class 3-

A

Activity evoking angina - walking < 2 blocks or < 1 flight of stairs
Limits to physical activity - marked

32
Q

CCS Functional Classification of Angina:

Class 4-

A

Activity evoking angina - minimal or at rest

Limits to physical activity - severe

33
Q

What is unstable angina brought on by?

A

exertion or other form of stress

34
Q

T/F unstable angina occurs at predictable heart rate.

A

False, Onset is unpredictable

35
Q

What type of prognosis if Crushing or squeezing substernal sensation with possible radiation to the arm with unstable angina?

A

Harbinger of bad things to come-poor prognosis

36
Q

T/F Ongoing unstable angina is a contraindication to symptom–limited maximal exercise testing

A

True

37
Q

What is the pathophysiology of stable angina?

A
  1. Fixed stenosis

2. Stable fibrous plaque

38
Q

What are the clinical features of stable angina?

A
  1. deman-led ischaemia
  2. related to effort
  3. predictable
  4. symptoms over long term
39
Q

What are the risk assessments of stable angina?

A
  1. symptoms on minimal exertion
  2. exercise testing (duration, degree of ecg changes, abnormal bp response)
  3. CT coronary angiogram
40
Q

What is the pathophysiology of acute coronary syndrome?

A
  1. Dynamix stenosis

2. ruptured or inflamed plaque

41
Q

What are the clinical features of acute coronary syndrome?

A
  1. supply-led ischaemia
  2. symptoms at rest
  3. unpredictable
  4. symptoms over short term
  5. frequent or nocturnal symptoms
42
Q

What are the risk assessments of acute coronary syndrome?

A
  1. ECG changes at rest
  2. ECG changes with symptoms
  3. Elevation of troponin
43
Q

What is the pathogenesis of an occlusive event leading to IHD?

A
  • Originates with plaques in the lumen of the arteries secondary to inflammation and lipid deposition
  • Plaque Rupture:
    Exposes thrombogenic lipids to the blood
    Stimulates localized thrombus formation with ischemic outcomes (CA occlusion)
  • Occlusive event
    Damage is dependent on coronary artery involved, time until treated
44
Q

A ruptured papillary muscle will lead to what?

A

Leads to acute mitral regurgitation and patients end up dying from pulmonary edema

45
Q

What is a myocardial infarction (MI)?

A

If ischemic insult is sufficiently long, tissue damage and death results

46
Q

T/F Lots of tissues in the body can suffer an infarction

A

True

47
Q

T/F Risk for an MI increases with increasing age.

A

True

48
Q

T/F MI mostly occurs in women.

A

False, MI’s are a disease of women as well as men

49
Q 
Describe the morphologic stages of myocardial infarction:
0-6 hrs - 
6-24 hrs - 
1-4 days - 
5-7 days -
A

0-6 hrs - No Change (Gross or Microscopic)
6-24 hrs - Early features of Coagulative Necrosis
1-4 days - Coagulative Necrosis with Acute Inflammatory Response
5-7 days - Macrophage Activity (phagocytic removal of dead myocytes

50
Q

Describe the morphologic stages of myocardial infarction:
7-10 days -
1-6 weeks -
1-3 months -

A

7-10 days - Developing peripheral rim of Granulation Tissue
1-6 wks - Progressive Organization of infarct
1-3 months - Progressive Collagen Deposition, Mature replacement scar

51
Q

If the area of injury from MI becomes a scar what will occur:

A
  1. Wall movement issues

2. Electrical propagation

52
Q

What is a reperfusion injury?

A
  • tissue damage caused when the blood supply returns to tissue (re- + perfusion) after a period of ischemia or lack of oxygen (anoxia or hypoxia)
  • increased permeability of capillaries and arterioles that lead to an increased diffusion and fluid filtration into the tissues
53
Q

What is sudden cardiac death? Caused by what?

A
  • natural unexpected death secondary to cardiac causes with rapid loss of consciousness
  • Patient has some cardiac issue that leads to sudden cessation of cardiac function (arrhythmia, MI, aneurysm)
54
Q

T/F Can survive sudden cardiac death.

A

True, however most patients will die within 24 hours

55
Q

What % of deaths from CAD are sudden cardiac death?

A

50%

56
Q

What are the anatomical findings of sudden cardiac death?

A
  1. Acute Coronary Plaque Rupture or Thrombosis
  2. Clinically quiet MI [minority of cases]
  3. No acute lesion but >60% stenosis of a coronary artery, often LAD (widow maker)

Pathophys (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions