Review Lecture Flashcards
Why is chest pain in a patient with stable angina brought on by exercise?
Blood flow to left coronary artery is reduced since diastole is shorter and diastole is when the left coronary artery fills the most
What is the primary mechanism by which GTN (glyceryl trinitrate) spray alleviates myocardial infarction in a patient with stable angina?
Dilation of systemic veins
This means that less blood fills the heart
Reducing the demand on the heart so it needs less O2
How can B blockers help with myocardial infarction?
Slows heart rate
More time in diastole so can fill with blood more
Reduces demand on heart
What are the 3 type so acute coronary syndromes going from least severe to most severe?
What causes the acute coronary syndromes?
Unstable angina
NSTEMI
STEMI
Caused by a plaque rupturing
Where may the pain of myocardial infarction radiate to?
Severe central crushing chest pain
May raider to neck, left shoulder and arm
If somebody has had a full thickness myocardial infarction. What will be present in there ECG weeks later indicating they’ve had an MI?
PATHOLOGICAL Q wave
If theres a sign of a STEMI with ST elevation in leads II, III and AvF which coronary artery is likely affected?
What view of the heart is being looked at?
Right coronary artery
Inferior view
Which side of the heart is lateral?
What group of ECG leads would ST elevation be present in a lateral infarct?
Left side of heart
Leads I, aVL, V5, V6
What findings would you have in an Acute anterolateral NSTEMI?
So what leads do you see a change?
What is the change?
Do you see troponin?
ST depression in leads I, AvL, V3, V4, V5 and V6 and presence of Troponin
What are the cardiac specific isoforms of troponin?
Troponin I and Troponin T
What is the function of Troponin?
Regulates skeletal and cardiac muscle contraction
What causes HFrEF (Reduced ejection fraction in heart failure)?
Systolic dysfunction inability to contract properly
What causes heart failure where the ejection fracture is preserved?
HFpEF
Diastolic dysfunction
Cant fill properly
Due to remodelling
Hypertrophy of LV has made it stiff
If a patient has an EDV of 120ml in their LV and an End Systolic Volume is 80ml what is her ejection fraction as a percentage?
120 - 80 = 40ml
40/120 = 0.33
Ejection fraction = 33%
If both ventricle of the heart fail what is this reffered to as?
Congestive heart failure