Study Flashcards
Systemic Thromboembolism describes emboli migrating through the __ (arterial/venous) circulation.
Arterial
A thrombus moving through the arterial system (systemic thromboembolism) is likely to be associate with …
- thrombi within heart wall–LV wall infarcts, dilated LA
- Ulcerated athersclerotic plaques
- Aortic aneurysms
Rheumatic heart disease is associated with …
mitral stenosis –> LA dilation –> augments stasis–> mural thrombus
What kind of thrombus is usually caused by cardiac problems?
arterial thrombus (associated with turbulence and EC injury)
PE in what sized vessels are more likely to infarct?
small vessels, which do not have collaterals like the medium vessels
if more than 60% of pulmonary circulation is blocked complications are :
- sudden death
- cor pulmonale
- cardiovascular collapse.
Pulm hypertension and Right Hrt Failure are associated with …
multiple PE’s
3 causes of arterial embolism (vs. venous)
- MI –> mural thrombus
- Rh Heart disease (mitral stenosis–> LA dilation->) to mural thrombus
- Arteriosclerosis
PE in medium size vessel is not likely to infarct but may be a problem with ___
Left ventricle failure.
aortic aneurysms are a form of this kind of thromboembolism:
systemic thromboembolisms
an area of ischemic necrosis due to occlusion of arterial supply or venous drainage is called …
Infarction
Most common cause of an infarct:
- thrombus/embolus that leads to arterial occlusion.
- Other causes: local vasospasm, swelling of atheroma (hemorrhage within a plaque), and compression of a vessel (tumor).
Atherosclerosis
- affects large and medium elastic/muscular arteries
- areas of bifurcation (like in edema)
increased LV end systolic volume means (volume/pressure)__ load, means what for the heart walls?
Volume load = dilatation = eccentric hypertrophy = baggy heart
more blood left in the heart after contraction, so LA dilates to accommodate volume.
Why do we see dyspnea and orthopnea in CHF?
Dyspnea = decreased lung compliance due to edema/congestion in lungs Orthopnea = trouble breathing when lying down, due to increased venous return.
CHF complications when it progresses to decompensated state
BACKWARD FAILURE into…
- pulmonary and systemic edema
- venous congestion
which cardiomyopathy predisposes ppl to sudden death and ventricular arrhythmia?
Hypertrophic – bc filling of ventricle during diastole is impaired (stiff muscular heart)
True aneurysms are bound by by the vascular wall, ex:
- atherosclerotic
- congenital vascular aneurysms
- left ventricular after a myocardial infarction
due to the nature of atherosclerosis, individuals with abdominal aortic aneurysms (AAA) are at high risk of ___ and ___
ischemic heart disease + stroke
what causes decompensated heart failure?
increased wall tension + underlying oxygen demand (heart works harder but already not getting enough O2)
forward failure vs. backward failure
forward = inadequate CO backward = venous backup
dilatation in CHF occurs in order to increase ___
preload!
in severe cases of ___ pts become cyanotic and acidotic
CHF
sudden cardiac death is associated with
- PE
- ruptured aortic aneurism
- infection
silent infarcts (without pain) are common in ___ and ___
- diabetics with HTN
- elderly
after surviving sudden cardiac death, majority of individuals develop __
- cardiac arrhythmias
- LV failure
- rupture of wall
- thromboembolism
in the first 20-30 min of infarction, MI affects whhc layer of the heart?
subendocardial region
then mid and subepicardial regions of myocardium.
ischemic heart disease can lead to 4 “syndromes”
- angina
- acute myocardial infarct/heart attack
- sudden cardiac death
- chronic ischemic heart disease + CHF! = ischemic cardiomyopathy
main cause of MI
coronary artery thrombosis
