Pathology of Ischemic Heart Disease Flashcards
Ischemic heart disease refers to ___________.
any disease in which myocardial oxygen demand exceeds supply
Exertional IHD is usually caused by __________, while unstable IHD is caused by ____________.
greater than 70% stenosis; greater than 90% stenosis
Most myocardial infarctions are due to _____________.
thrombi formed on atherosclerotic plaques
In terms of myocardial damage, MIs start in ___________.
the subendocardial area
Subendocardial injuries result from __________.
hypoperfusion episodes in over atherosclerotic sites
Unstable angina results from greater than ______ percent stenosis.
90
Describe chronic ischemic heart disease.
Progressive cardiac decompensation following an acute infarct or multiple small ischemic events with development of contractile impairment
Erosion plaques can cause coronary thrombosis, but they are __________.
less common
Subendocardial infarcts frequently result from ____________.
hypoperfusion, hypotension, or hypoxia in the presence of an atherosclerotic plaque
Irreversible damage to the myocardium begins at _________ minutes following of ischemia.
60
Coagulative necrosis and neutrophil infiltration begin at ________ hours following an infarction and peak by _______ hours.
18; 72
Following an infarction, macrophages arrive at _________, granulation tissue starts at _______, and fibrosis begins at ________.
4-7 days; 10 days; 4-8 weeks
Infarction that causes papillary muscle death can lead to _________.
AV valve regurgitation
Rupture of the cardiac wall can result when macrophages have removed dead cells and before the tissue is fibrosed, which is ________.
2-10 days after an infarction
Where do berry aneurysms occur, and with what disease are they associated?
At the bifurcation of the cerebral arteries and with polycystic kidney disease
