Ischaemia & Infarction Flashcards

1
Q

What are the commonest causes of coronary ischaemia

A

Coronary Arterial Atheroma
Pulmonary Oedema (usually due to LVF)
Heart Failure
Previous MI
Anaemia
Exertion/stress

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2
Q

What causes stable angina vs unstable angina

A

Stable angina is most often caused by a coronary atheroma which occludes flow and so on exertion or stress when the demand increases the arteries cant meet it.
Unstable Angina (UAP) is caused by a complicated Atheroma with a growing thrombus, this grows over days or weeks causing the crescendo pattern of UAP.

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3
Q

What are the three types of ischaemia?

A

Acute
Chronic
Acute-on-chronic

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4
Q

What is the difference between ischaemia & infarction?

A

Infarction is a complete loss of blood supply leading to a build up of CO2 & Lactic Acid which causes necrosis.
Ischaemia is only partial and doesn’t involve necrosis

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5
Q

What is repurfusion injury?

A

When circulation returns to an infarcted area the environment is so changed that the returning supply causes inflammation & oxidative damage which often further harms the tissue

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6
Q

What are the two types of necrosis?

A

Coagulative - The structure remains in place for some time even as the tissue dies and is digested
Colliquative - The tissue is transformed into a liquid viscous mass

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7
Q

What type of necrosis occurs in the heart due to infarction?

A

Coagulative

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8
Q

Whats a transmural vs subendocardial MI?

A

A transmural MI affects the full thickness of the myocardium
A subendocardial MI is mainly limited to the myocardium just under the endocardial lining

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9
Q

How do we distinguish Angina - UAP - NSTEMI - STEMI?

A

Angina - Pain on exertion, stable, stops on rest
UAP - Pain on increasingly little exertion (crescendo pattern)
NSTEMI - Elevated cTn (cardiac Troponin) levels indicates necrosis separating it from UAP
STEMI - ST elevation

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10
Q

Name some possible complications of MIs and the 3 classes?

A

classes: Immediate - Early - Late

Complications:
Arrhythmia - Angina - Cardiac failure or rupture - Reinfarction - Pericarditis - DVT (with PE) - Mitral Incompetence - Papillary Muscle Dysfunction - Ventricular Aneurysm - Dressler’s Syndrome - Sudden Death

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