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CV II Exam 2 > Pathology of the Heart III > Flashcards

Pathology of the Heart III Flashcards

1
Q

C reactive protein

A

marker for inflammation

levels of 1-3 - moderate risk for coronary heart disease

atherosclerotic plaques - cause sustained chronic inflammation

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2
Q

prinzmetal angina

A

sustained vasospasm causing angina

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3
Q

cardiac raynaud

A

cold or emotion induced cardiac vasospasm

-> 20 mins - can lead to MI

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4
Q

takotsubo cardiomyopathy

A

dilated cardiomyopathy - secondary to emotional or physical stress with normal coronary angiogram

repeated bouts of vasospasm

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5
Q

cocaine

A

can cause vasospasm

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6
Q

sudden cardiac death

A

unexpected death from cardiac cause early after onset of symptoms (1-24 hours)

or sudden death from cardiac cause without acute symptoms

normally - lethal arrhythmia - V-fib

caused by IHD

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7
Q

channelopathies

A

K, Na, Ca channel problems

-most autosomal dominant

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8
Q

brugada syndrome

A

ST elevation and RBBB

syncope or sudden cardiac death during rest, sleep, after large meals

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9
Q

CPVT syndrome

A

childhood life threatening arrhythmias
-stress induced

no EKG changes

change in diastolic Ca release

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10
Q

non-ischemic SCD

A

people < 40yo

majority hypertrophic cardiomyopathy

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11
Q

commotio cordis

A

set off arrhythmia by poking individual in chest

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12
Q

chronic IHD

A

CHF in pt with previous MIs and angina

LVH and dilation

myocardial fibrosis - past MI

arrhythmia, CHF, MI develop

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13
Q

myocyte hibernation

A

chronic ischemia that does not cause necrosis - hypokinetic myocardium

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14
Q

angina pectoris

A

recurrent substernal discombort

ischemia falling short of inducing necrosis

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15
Q

stable angina

A

with exertion

goes away with rest

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16
Q

unstable angina

A

crescendo

  • acute plaque change
  • may occur at rest
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17
Q

prinzmetal angina

A

coronary vasospasm

-relieved with rest, nitro, and CCBs

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18
Q

longer than 20 minutes

A

kill myocytes

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19
Q

MI

A

death of cardiac muscle from ischemia

more in men

> 65 yo higher risk

20
Q

stain for MI

A

triphenyltetrazolium chloride

  • viable - red
  • non-viable - pale
21
Q

transmural infarct

A

more than half - around 75%

22
Q

subendo infarct

A

less than half

23
Q

balloon angioplasty

A

do within 6 hours

-after this time - unsalvagable necrosis

24
Q

gross changes with MI

A

dark mottling by 12 hours

1-3 days yellow-tan infarct center
1 week hyperemic border with yellow-tan softening
10 days yellow-tan/soft depressed red-tan margins
2 weeks red-gray borders
2 months - white scar

25
Q

micro changes with MI

A 
waviness - earliest change - 4 hours or so
4-12 hrs - coaguative necrosis
12-24 hours - neutrophils
1-3 days - lots of neutrophils
3-7 days early phagocytosis
7-10 days granulation tissue forms at margins
10-14 days lots of granulation tissue
2-8 weeks - collagen deposition
2 months - dense collagen scar
26
Q

MI with neutrophils

A

1-3 days old

27
Q

MI with no neutrophils

A

less than 1 day old

28
Q

MI with macrophages

A

1 week old

29
Q

MI with granulation tissue and collagen

A

2 weeks old

30
Q

MI with pure scar

A

months old

31
Q

occluded LAD

A

most common

widowmaker

32
Q

occluded RCA

A

arrhythmias

33
Q

MI reperfusion techniques

A

lysis - tPA, streptokinase, urokinase
bypass graft
-balloon angioplasty

with thrombolytic drugs - cannot do procedure until drugs are gone**

34
Q

reperfusion after 6 hours

A

does not reduce MI size

35
Q

stunning

A

viable tissue but non-functional after MI
-is reversible

reperfusion 2-4 hours after MI

36
Q

pathology of reperfusion

A

arrhythmias
hemorrhage with contraction bands
no-reflow (capillary closure)
-stunning

37
Q

MI clinical Sx

A

chest pain, radiate left arm, neck, jaw

weak pulse rapid
sweating
nausea
dyspnea

38
Q

STEMI

A

transmural

39
Q

NSTEMI

A

subendocardial

40
Q

troponins for heart

A

I and T

slower rise and fall

5 to 10 days to fall

41
Q

CK for heart

A

CK-MB

quick rise and fall

decreased by 2-3 days

42
Q

myoglobin

A

used to exclude MI
-no myoglobin - no MI

yes myoglobin - could be lots of reasons
quick rise and fall - decreased by 24 hours

43
Q

serial cardiac enzymes

A

taken every 2 hours or so

44
Q

CK-MB low and troponin high

A

more than 3 days ago

45
Q

CK-MB high and troponin high

A

current MI

46
Q

complications of MI

A

myocardial rupture - VSD, papillary (regurg), cardiac tamponade

pericarditis

right ventricular infarction

infarct extension and expansion (dilation and thinning of heart)

mural thrombus

ventricular aneurysm

CV II Exam 2 (18 decks)

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