Nov22 M3-Pathology - Coronary Artery Disease COPY

Question 1

ischemic heart disease and causes

Answer 1

imbalance of supply demand to myocardium. 90% caused by CAD. also anemia, low flow states

Question 2

critical stenosis def + why

Answer 2

70% stenosis, no symptoms below that

Question 3

90% stenosis problem

Answer 3

symptoms at rest

Question 4

stable vs unstable angina

Answer 4

stable = occurs at predictable lvl of exercise
unstable = happening with less and less exertion

Question 5

acute MI def

Answer 5

cardiomyocyte death

Question 6

acute coronary syndrome includes what

Answer 6

unstable angina, acute MI, SCD (sudden cardiac death)

Question 7

subendocardial vs transmural infarct causes

Answer 7

subendocardial if partially occlusive thrombus (can also give unstable angina). transmural MI if completely occlusive thrombus

Question 8

angina phenomenon happening

Answer 8

ischemia

Question 9

why infarct initially subendocardial and then dev to transmural

Answer 9

because receives most pressure (most compression on vessels) + furthest from coronaries. infarction progresses towards epicardium

Question 10

subendocardial infarct starts with _______

Answer 10

incomplete stenosis

Question 11

subendocardial vs transmural MI on ECG

Answer 11

subend: no Q wave, ST depression, T wave inversion, NSTEMI

transmural MI: STEMI. Q waves, St elevation

Question 12

LAD stenosis consequence

Answer 12

antero-septal subendocardial MI

Question 13

posterior descending stenosis conseq

Answer 13

postero-septal subendocardial MI

Question 14

RCA, LAD and LCX stenosis conseq

Answer 14

circumferential subendocardial MI

Question 15

LAD complete occlusion conseq

Answer 15

anteroseptal transmural MI

Question 16

RCA complete occlusion conseq

Answer 16

postero-septal transmural MI

Question 17

microscope findings after infarct 1 day

Answer 17

wavy fibers, eosinophilic

Question 18

microscope findings after infarct 2-3 days

Answer 18

PMNs infiltration

Question 19

microscope findings after infarct 7-10 days

Answer 19

macrophages clean (eat dead myocyte) + neutrophils gone

Question 20

microscope findings after infarct 14 days

Answer 20

new vessels, collagen (granulation tissue)

Question 21

microscope findings after infarct 7 weeks+

Answer 21

collagen scar

Question 22

main complications of MI

Answer 22

HF, cardiogenic shock, arrhythmias, vent rupture (tamponade), mural thrombus and embolism, septum shunt, valve dysfct (if pap muscle)