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Cardio-Renal > Pathology of Coronary Artery Disease > Flashcards

Pathology of Coronary Artery Disease Flashcards

1
Q

What is the most common cause of coronary artery disease?

A

Atherosclerosis

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2
Q

How long after an MI would you expect to find a neutrophilic infiltrate on histological analysis?

A

1-3 days

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3
Q

What finding on an ECG may indicated an NSTEMI?

A

ST segment depression

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4
Q

What three pathologies are considered Acute Coronary Syndrome?

A

Angina pectoris, myocardial infarction, sudden cardiac death

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5
Q

What type of angina is associated with ST segment elevation that mimics an acute MI?

A

Prinzmetal angina

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6
Q

What type of MI is causes by a transmural infarct.

A

STEMI - a subendocardial infarct causes an NSTEMI

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7
Q

Following ischemia, what region of myocardium is most susceptible to damage?

A

Subendocardium - this region is supplied by the distal coronary arteries.

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8
Q

What is the most common cause of sudden cardiac death in young athletes?

A

Hypertrophic cardiomyopathy

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9
Q

A patient is told they have a heart murmur following an MI 6 days ago. What is the cause?

A

Rupture of the papillary muscle - likely posterior leaflet

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10
Q

True/False. An acute MI may present as heart failure, before permanent myocyte death.

A

True - this is because contractility ceases within a minute of ischemia

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11
Q

What is the most common cause of death in the first 24 hours following an MI?

A

Arrhythmias

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12
Q

What is the cause of prinzmetal angina?

A

Coronary artery spasm that is unrelated to activity

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13
Q

Mitral regurgitation is common with a myocardial infarct of right coronary artery. Why is this?

A

The RCA supplies the posterior papillary muscle, which ruptures without blood supply

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14
Q

What illicit drug is most associated with sudden cardiac death?

A

Cocaine - causes coronary artery vasospasm

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15
Q

A patient presents to the ED with an acute MI that began 1 hour before. Unfortunately, the patient expires shortly after arrival. What histologic changes would you expect to see?

A

None - there are no gross or histologic changes in the first 3 hours following an MI

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16
Q

True/False. Women are at higher risk for acute MI than men.

A

False - women are protected by estrogens and at lesser risk of MI. This protection dissipates with menopause.

17
Q

A patient had a confirmed MI 5 days ago. They now have new onset angina. Cardiac enzymes are tested and reveal elevated troponin, with normal CK-MB. Is this a new infarct?

A

No - troponin remains elevated for up to 10 days following an infarct. CK-MB is elevated up to 3 days

18
Q

Stable angina presents with pain upon exertion that is relieved with rest. How much of the vessel lumen is obstructured?

A

Greater than 70%, but less than 90%

19
Q

What histologic changes occur within 3-24 hours following a myocardial infarct?

A

Wavy fibers with edema, contraction band necrosis, neutrophils

20
Q

What is Dressler Syndrome?

A

Fibrinous myocarditis caused 2-3 weeks post-MI, often due to an autoimmune reaction

21
Q

True/False. Unstable angina indicates a myocardial infaraction is imminent/

A

True - the patient must be monitored and treated. Vessel occlusion is greater than 90%, but less than 100% (MI)

22
Q

What cardiac enzymes will be present 12 hours following an infarct.

A

Troponin & CK-MB

23
Q

A patient experienced an MI 5 days ago. Upon examination today, heart sounds are muffled. What is the likely cause?

A

Ventricular rupture

24
Q

True/False. Myocytes dies within a minute of ischemia.

A

False - contractility ceases within a minute of ischemia. Myocytes take 20-30 mins to die wihout O2 supply

25
Q

What population is most commonly affected by prinzmetal angina?

A

Women 20-30yrs

26
Q

A patient had an MI 5 days ago. What cells predominate on histological analysis?

A

Macrophages - days 3-10

27
Q

A transmural infarct causes a STEMI. What ECG finding is permanent following a transmural MI?

A

Exaggerated Q wave

28
Q

What is a circumferential subendocardial infarct?

A

Global hypoperfusion of the heart caused by hypovolemia or hypotension in a patient with atherosclerosis of the coronary arteries

29
Q

What is the most common cause of right heart failure?

A

Left heart failure

30
Q

What is Cor Pulmonale?

A

Right heart failure caused by a primary lung problem (COPD, emphysema, pulmonary hypertension, etc.)

31
Q

How long does it take for an myocardial infarct to become transmural?

A

Approximately 6 hours

32
Q

What coronary artery is most often blocked with a posterior papillary muscle rupture?

A

Right coronary artery

33
Q

A patient experiences a myocardial rupture following an acute MI. What type of MI did they have?

A

Transmural infarct (STEMI)

Cardio-Renal (37 decks)

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