L4: Ischemic Heart Disease Flashcards
What is the term for pathologic processes affecting the coronary arteries (atherosclerosis)
Coronary Artery Disease (CAD)
What is the term for diagnoses including angina pectoris, MI, silent MI, and mortality resulting from CAD?
Coronary Heart Disease (CHD)
What is the term for the pathologic process affecting the entire arterial circulation, resulting in stroke, TIA, angina, MI, claudication, and critical limb ischemia?
Cardiovascular Disease (CVD)
What is the term for irreversible death of the heart muscle due to prolonged lack of O2?
Myocardial Infarction (MI)
Where are the main arteries of the hard located? When does most perfusion occur?
Epicardial region (opposed to endocardium) Most perfusion occurs during diastole
Atheroscleortic plaques form: (2)
- Sites of increased blood turbulence
- Branching points in the epicardial arteries
What is ischemic heart disease?
Condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium
O2 demand > O2 supply
What is the leading cause of death in the US? Is it more common in males or females?
Coronary Heart Disease (CHD)
M > F
__________ is the initial coronary event in 15% of patients with CHD.
Sudden Cardiac Death (SCD)
When does atherosclerosis begin?
Childhood
What is the role of nitric oxide in terms of our blood vessels?
- Endothelial cells produce NO
- NO inhibits plaque formation and has anti-inflammatory properties
- NO keeps our blood flowing smoothly, eliminates plaque, and vasodilates
What causes endothelial dysfunction?
LDL and oxidized LDL = leads to atherosclerosis
What has an “atheroprotective” role in our vessels? Why?
HDL: anti-inflammatory and anti-oxidant properties
What are the modifiable risk factors for IHD (7)?
- Diet
- Inactivity
- Obesity
- Cigarette smoking
- HTN
- DM
- Dyslipidemia (high LDL, low HDL, high triglycerides)
At what age are men most at risk for developing IHD? Women?
M > 45 years old
W > 55 years old
Almost 2/3rds of women who die suddenly from CHD have:
NO previous symptoms!
Atypical symptoms associated with IHD are more common in:
- Women
- Elderly
- Patients with diabetes
Why do women often have increased mortality with IHD?
Often present without chest pain!
Delayed dx + delayed tx = increased mortality
In what situations are women more likely to die from IHD?
Greater likelihood of being induced by rest, sleep, and mental stress (rather than activity)
Transient ischemia may result in:
Angina pectoris
Prolonged ischemia may result in:
Myocardial infarction
Which condition may cause sx that urge patients to seek medical care, may be confused with other disorders, and may be completely “silent”?
Myocardial ischemia
What conditions fall under the umbrella of acute coronary syndrome?
- Unstable angina
- MI
- Non-ST elevation MI (NSTEMI)
- ST elevation MI (STEMI)
Define stable angina (angina pectoris).
Exertional or stress-related chest or arm discomfort that resolves with rest and/or the use of sublingual nitroglycerin