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Phar 471 > Myocardial Infarction > Flashcards

Myocardial Infarction Flashcards

1
Q

Which artery provides 2/3 of blood to anterior wall and septum?

A

Left anterior descending artery

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2
Q

Which artery supplies the left ventricle?

A

Left circumflex artery

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3
Q

Which artery supplies (1/3) of the blood to posterior of septum?

A

Right posterior descending artery

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4
Q

Which coronary artery supplies the pacemaker?

A

Right coronary artery

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5
Q

Which artery supplies the right ventricle

A

Acute marginal arteries

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6
Q

Which layer of the pericardium is connected to the epicardium?

A

Visceral pericardium

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7
Q

What is the function of fibrous pericardium?

A

To provide protection, anchor, and limit the heart volume (prevent overfilling)

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8
Q

Name the 3 layers of the heart from most inner to outer.

A

Endocardium, Myocardium, Epicardium

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9
Q

How many litres of blood is pumped per minute?

A

5L

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10
Q

What causes an increase in myocardial oxygen demand?

A

Increase HR, Increase diastolic volume, Increase contractility, Increase blood pressure

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11
Q

What causes a decrease in myocardial oxygen supply?

A

Decrease coronary blood flow, Decrease oxygen content, decrease hematocrit, decrease oxygen saturation, coronary vasoconstriction, coronary thrombosis, increase HR, increase diastolic volume

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12
Q

What are the disease states that are risk factors for MI?

A

Hypertension, Peripheral vascular disease, Hypercholesterolemia, Hyperglycemia, Stroke

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13
Q

Acute Coronary Syndrome encompasses these conditions.

A

Unstable angina (changing/worsening chest pain); MI; Sudden cardiac death

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14
Q

In sudden cardiac death, there is extensive necrosis of the tissue. (T or F)

A

False, there is limited necrosis because the tissues need time to necrose; with sudden cardiac death the tissues have just been damaged.

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15
Q

The variant form of angina pectoris is defined by…

A

Pain occurring at rest due to vasospasm or constriction of artery diameter

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16
Q

The stable form of angina pectoris is defined by…

A

Pain occurring only during exertion

17
Q

Which form of angina pectoris is frequently missed and treated as acute coronary disease?

A

Variant/Printzmetal’s Angina

18
Q

Printzmetal’s angina occurs in how much percent of angina patients?

A

2-10%

19
Q

Is atherosclerosis a cause for variant angina?

A

No, but 30% of patients have concurrent atherosclerosis

20
Q

What are the 2 types of MI and what’s the difference?

A

Transmural infarction affects full thickness of ventricular wall
Sub-Endocardial Infarcton affects inner 1/3 to 1/2 of ventricular wall

21
Q

The fewer collateral blood vessels in the region, the (greater/lesser) risk of damage.

A

Greater risk because collateral blood vessels provide alternate routes to regions.

22
Q

What are the factors impacting the size of infarct region?

A

1) Severity/Duration of Ischemia
2) Location of block
3) Metabolic needs of region
4) Collateral blood vessels
5) Heart rate/rhythm
6) BP

23
Q

Which cardiac enzyme has high specificity for cardiac damage?

A

Cardiac troponin (T&I)

24
Q

Which lactate dehydrogenase is specific for the heart?

A

LDH -1; this isozyme is dominant in the heart

25
Q

Which 2 cardiac enzymes/markers are non-specific to MI?

A

Myoglobin and Creatine Kinase; they can increase as result of muscle injury/exercise damage

26
Q

When can cardiac troponin be measured to detect MI?

A

Levels increase 2 hours post MI and lasts for < 2 weeks; levels spike for 12 hours long

27
Q

When can lactate dehydrogenase be measured to detect MI?

A

Up to 72 hours post MI

28
Q

Which test can detect silent ischemia?

A

A stress test/exercise intolerance test

29
Q

A T wave inversion is indicative of…

A

Disrupted ventricular repolarization

30
Q

A ST elevation is indicative of…

A

Abnormal electrical potential

Phar 471 (5 decks)

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