pathology of ischemic heart disease Flashcards
What is leading cause of death for men and women in US and other industrialized nations
- ischemic heart disease
what are the risk factors for IHD
- DM
- HTN
- smoking
- lipids
what is general cause of IHD, and what are seom things that can cause this?
- imbalance of O2 supply and demand
MOST due to atheroscleortic CAD
- hypotenstion
- coronary artery vasospam (cocaine abuse)
what are some exacerbating conditions of IHD?
- myocardial hypertrophy
- shock
- hypoxemia/anemia
- increased HR
Name four clinical manifestations of IHD
- angina pectoris
- myocardial infarction
- chronic IHD
- sudden cardiac death
What is angina pectoris caused by?
- ischemia… results in cellular necrosis and metabolic spil
what are the 3 causes of angina pectoris
- stable (most common) due to reduced perfusion and ischemia with increased oxygen demand
- prinzmetal – uncommon, episodic, occurs at REST… coronary artery vasospasm is involved
- Unstable – pain that is progressively more frequent and intense; occurs progressively with less effort
what are the 3 acute coronary syndromes
- unstable angina
- acute mI
- sudden death
what are the three coronary artery perfusion zones?
- LAD (40-50% of MI – anteiror lv wall; anterior ventricular septum, apex
- RCA (30-40% of MI – inferoposterior lv wall; posterrior ventricular septum, and inferoposterior rv
- LCX (15-20 percent) – lateral wall of LV expect apex
What is the difference in EKG reading between transmural and subendocardial
transumral: q waves and st abnormal
subendocardial (not full thickness) ; non q wave
name some chest pain etiologies
- IHD
- pericarditis
- MSK
- PE
- peptic ulcer
- IHD
What is time frame of rise of CK-MB? when does it peak and when does it go to normal?
- rises 4-8 hrs after injury; peaks at 18 hours and normal by day 3
what is troponin biomarker of? what does it regulate?
describe elevation in relaetion to MI and how long does it remain high?
- biomarker of myocardial dmage
- regulates ca-mediated mediated contraciton of muscle
- elevation occurs within 4 hours after MI; levels remain high for 7-14 days
name some causes of non-mi troponin elevations
- pericarditis
- hert faiulre
- extreme physical exertion
- sepsis
- shock
- renail failure
- PE (due to right heart strain)
- cerebrovascular accident
name some characteristice events in MI
- inciting factor = sudden disruption of atheromatous plaque
- platelet adhesion and activation
- activaiton of coag pathway to give
- lumen occlusion