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Cardiovascular > Pathophysiology of Ischaemia and Infarction > Flashcards

Pathophysiology of Ischaemia and Infarction Flashcards

1
Q

What are the two reasons for ischaemic heart disease?

A

Supply issues

Demand issues

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2
Q

What kind of supply issues can cause ischaemic heart disease?

A 
Coronary artery atheroma 
Cardiac failure 
Pulmonary function 
Pulmonary oedema 
Anaemia 
Previous MI
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3
Q

What kind of demand issues cause ischaemic heart disease?

A

Heart has a high intrinsic demand due to exertion or stress

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4
Q

What is the outcome of Ischaemia?

A

Can be no clinical effect
Resolution on its own or with therapeutic intervention
Infarction

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5
Q

What factors affect the scale of damage of infarction?

A

Time period
Tissue or organ
Pattern of blood supply
Previous disease

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6
Q

How long does severe iscahemia take to cause irreversible damage?

A

20-30 minutes

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7
Q

What is infarction?

A

Obstruction of the blood supply to an organ or region of tissue, typically by a thrombus or embolus, causing local death of the tissue

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8
Q

What is stagnant hypoxia?

A

Normal inspired O2 but abnormal delivery

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9
Q

What is cytotoxic hypoxia?

A

Normal inspired oxygen but abnormal at tissue level

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10
Q

What causes stagnant hypoxia?

A

Local effects such as occlusion of vessels

Systemic effects such as shock

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11
Q

What are the reparative processes that happen in order during myocardial infarctions?

A
  1. Cell death
  2. Acute inflammation
  3. Macrophage phagocytosis of dead cells
  4. Granulation tissue
  5. Collagen deposition (fibrosis)
  6. Scar formation
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12
Q

How long does it take for the formation of dense collagenous scars in an MI?

A

2 months or more

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13
Q

What are the effects of infarction?

A

Death

Dysfunction

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14
Q

What is a myocardial infarction?

A

Myocardial infarction is the partial death of heart tissue commonly known as heart attack.

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15
Q

What is ischaemia?

A

Relative lack of blood supply to a tissue or organ leading to inadequate oxygen supply to meet the needs of that tissue or organ

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16
Q

What are the factors affecting oxygen supply?

A 
Inspired oxygen 
Pulmonary function 
Blood constituents 
Blood flow 
Integrity of vasculature 
Tissue mechanisms
17
Q

What is atheroma or atherosclerosis?

A

Localised accumulation of lipid and fibrous tissue in the intima of arteries

18
Q

What does atheroma in the aorta cause?

A

An aneurysm

19
Q

What does an established atheroma in a coronary artery cause?

A

Stable angina

20
Q

What does a complicated atheroma in a coronary artery cause?

A

Unstable angina

21
Q

What does an ulcerated or fissured plaque cause?

A

Thrombosis which leads to ischaemia or infarction

22
Q

What are the clinical consequences of an atheroma?

A 
MI 
Transient ischaemic attack 
Cerebral infarction 
Abdominal aortic aneurysm 
Peripheral vascular disease 
Cardiac failure
23
Q

What is the clinical effect of Ischaemia?

A

Dysfunction
Pain
Physical damage of cells

24
Q

What are the possible outcomes of ischaemia?

A

No clinical effect
Resolution on its own or by therapeutic intervention
Infarction

25
Q

What can cause an infarction?

A

Thrombosis
Embolism
Strangulation
Trauma

26
Q

What are the two outcomes of infarction?

A

Coagulative necrosis

Colliquitive necrosis

27
Q

Where can coagulative necrosis happen?

A

Heart

Lungs

28
Q

Where can colliquitive necrosis happen?

A

Brain

29
Q

What is coagulative necrosis?

A

Necrosis where the tissue holds its structure for several days

30
Q

What is colliquitive necrosis?

A

Necrosis that turns the tissue into a liquid viscous mass

31
Q

What does the end result of an infarct look like?

A

Scar replaces area of tissue damage

Shape depends on territory of occluded vessel

Cardiovascular (34 decks)

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