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CRRAB Week 2 - WLB > Ischemic Heart Disease (Pathoma) > Flashcards

Ischemic Heart Disease (Pathoma) Flashcards

1
Q

ischemia

A

refers to decrease in blood flow to an organ

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2
Q

angina

A

chest pain that is REVERSIBLE

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3
Q

stable angina

A
  • no chest pain at rest

- develops chest pain with exertion or emotional stress

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4
Q

When does angina occur?

A

When there is >70% stenosis

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5
Q

How long does chest pain last in stable angina?

A
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6
Q

EKG findings in stable angina?

A

ST segment DEPRESSION (only subendocardial ischemia)

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7
Q

How is stable angina relieved?

A
  • Rest (decrease O2 demand of myocardium)

- Nitro (venous dilation, decrease preload, decrease myocardial stress)

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8
Q

unstable angina

A

chest pain that occurs at rest

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9
Q

What causes unstable angina?

A

rupture of atherosclerotic plaque

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10
Q

Is unstable angina due to complete or incomplete occlusion of a coronary artery?

A

INCOMPLETE

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11
Q

EKG findings in unstable angina?

A

ST segment DEPRESSION (only subendocardial ischemia)

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12
Q

EKG findings in unstable angina?

A

ST segment DEPRESSION (only subendocardial ischemia)

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13
Q

Sx of Prinzmetal angina?

A

episodic chest pain unrelated to exertion

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14
Q

Complications of Fibrinolysis or Angioplasty?

A
  • contraction band necrosis (return blood & calcium, cause contraction of dead tissue)
  • reperfusion injury (return O2, release free radicals)
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15
Q

How is unstable angina relieved?

A
  • Nitro

- High risk of progressing to MI

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16
Q

1-3 days after MI?

A
  • Yellow pallor (due to leukocytes)
  • Inflammation
  • Neutrophils (clean up necrosis)
  • Fibrinous pericarditis (chest pain with friction rub)
17
Q

4-7 days after MI?

A
  • Healing
  • Macrophages
  • Granulation tissue (fibroblasts, collagen, and blood vessels)
  • Rupture of ventricular free wall, cardiac tamponade
18
Q

Months after MI?

A
  • White Scar
  • Fibrosis
  • Aneurysm, mural thrombosis, Dressler’s Syndrome (antibodies against pericardium 6-8 weeks out)
19
Q

What is Dressler’s Syndrome?

A
  • Autoimmune reaction 6-8 weeks post MI.

- Develop antibodies that attack pericardium.

20
Q

What type of infarction does Fibrinous pericarditis occur with?

A

ONLY occurs with TRANSMURAL infarction

1-3 days post-MI

21
Q

Myocardial infarction

A

necrosis of myocytes

22
Q

What causes sudden cardiac death?

A

Fatal ventricular arrhythmia

23
Q

Chest pain in MI?

A

> 20 min (not relieved by Nitro)

24
Q

What is treatment for MI?

A
  • Aspirin/Heparin
  • Supplemental O2
  • Nitrates (decrease preload, decrease demand)
  • Beta-blocker (slow HR, decrease O2 demand, decrease risk for arrhythmia)
  • ACE Inhibitor (decrease afterload, decrease LV dilation)
25
Q

Complications of Fibrinolysis or Angioplasty?

A
  • contraction band necrosis (return blood & calcium, cause contraction of dead tissue)
  • reperfusion injury (return O2, release free radicals)
26
Q

4-24 hours after MI?

A
  • Dark discoloration
  • Coagulative necrosis (remove nucleus of cell)
  • Arrhythmia
27
Q

1-3 days after MI?

A
  • Yellow pallor
  • Inflammation
  • Neutrophils (clean up necrosis)
  • Fibrinous pericarditis (chest pain with friction rub)
28
Q

4-7 days after MI?

A
  • Healing

- Granulation tissue (fibroblasts, collagen, and blood vessels)

29
Q

Months after MI?

A
  • White Scar
  • Fibrosis
  • Aneurysm, mural thrombosis, Dressler’s Syndrome
30
Q

What is Dressler’s Syndrome?

A
  • Autoimmune reaction 6-8 weeks post MI.

- Develop antibodies that attack pericardium.

31
Q

What type of infarction does Fibrinous pericarditis occur with?

A

ONLY occurs with TRANSMURAL infarction

1-3 days post-MI

32
Q

What are the most common etiologies of acute ischemia in sudden cardiac death?

A
  • Pre-existing severe athersosclerosis (90%)

- Less common: mitral valve prolapse, cardiomyopathy, cocaine abuse (vasospasm)

33
Q

What causes Chronic Ischemic Heart Disease?

A

Poor myocardial funciton due to chronic ischemic damage (with or without myocardial infarction)

34
Q

What does Chronic Ischemic Heart Disease progress to?

A

CHF

CRRAB Week 2 - WLB (9 decks)

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