Ischemic heart disease part 1 Flashcards
How common are heart attacks in US
someone has a heart attack every 40 seconds
how many heart attacks are silent
1 in 5
what are the MC risk factors for ischemic heart disease (IHD)
- genetics
- high fat and energy rich diet
- smoking
- sedentary lifestyle
what group is IHD growing among
low-income groups
what is the pathogenesis of IHD
the heart muscle is not perfused with blood leading to improper oxygenation and ischemic results.
(in notes)
what is the mechanism of myocaridal ischemia
very multifactoral but egnerally an imbalance between oxygen supply and demand.
what is oxygen supply determined by
blood flow which is regulated by pressure vs. resistance ratio
what is the most critical factor of blood flow and therefore oxygen supply
the radius of the blood vessel
what can influence the radius of the blood vessel
This is influenced by atherosclerosis hardening of vessels, vascular tone, and endothelial cell dysfunction in cardiac ischemia
what is the MCC of IHD
atherosclerosis (in notes slide 11)
what is considered a silent heart attack
found after the fact or incidentally due to symptoms not being indicative of myocardial infarction
(said in class)
what are the types of ischemic heart disease
- prinzmetal angina
- stbale angina
- unstable angina
- MI (stemi/nstemi)
what is included in acute coronary artery syndrome?
- unstable angina
- MI (stemi/nstemi)
flip to see a picture example of unstable, chronic stable and prinzmetal angina.
what is acute coronary syndrome
ACS results when there is plaque rupture and thrombus formation.
what determines the severity of ACS
the amount of coronary blood flow restriction
what are the three severity types of ACS
- unstable angina - no occluded blood flow in coronary vessels but unstable plaque is still present leading to symptoms at rest
- NSTEMI - partially impeded blood flow through the coronary vessels
- STEMI - completely impeded blood flow through the coronary vessels
what is STABLE angina?
- fixed stenosis!
- occurs when the heart is under stress and needs more oxygen (exercise, cold, emotions)
how long does STABLE angina typically last
- 1-15 minutes
- goes away with rest and/or NTG
- may continue without much change for years
(i assume this means it is intermittent!)
how does the pattern of unstable angina differ from stable angina
- unstable angina is unexpected and a change in your usual pattern of stable angina
- does NOT go away with nitroglycerin
- considered an EMERGENCY. wanring that an MI is impending
what is prinzmetal angina
spasm of the vessel leading to reduced vessel diameter or decreased pressure, like in hypotension, that leads to poor perfusion
(said in class and at bottom of slide 11)
after occlusion of a coronary artery, the myocardium involves through various stages and degrees of severity of impact. what are these stages?
- ischemia
- injury
- infarction