Cardiac Path 4 (CAD/MIs) COPY Flashcards

1
Q

What disease is the following in reference to?

  • Atherosclerosis of the coronaries which presents as myocardial ischemia owing to a slowly progressive narrowing by atherosclerosis or a sudden occlusion due to a thrombus.
  • Chronic ischemia leads to CHF
A

Coronary Artery Disease

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2
Q

What disease is the following in reference to?

-Chronic progressive ischemia results in hypoperfusion of the myocardium and slowly evolving CHF

A

CAD

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3
Q
  • Acute coronary thrombosis is more common in arteries already narrowed by __________
A

Atherosclerosis

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4
Q

What does sudden occlusion of a major coronary artery cause and does the location of the arterial occlusion differ?

A

Results in an Myocardial Infarct in an anatomically defined area

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5
Q

An anterior wall infarct is typically caused by occlusion of the ____________ coronary artery

A

Left anterior descending

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6
Q

An infarct of the lateral wall of the left ventricle is usually caused by occlusion of the ________ coronary artery.

A

left circumflex

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7
Q

An infarct of the right ventricle and posterior wall of the left ventricle is usually caused by occlusion of the ________ coronary artery.

A

Right Coronary Artery

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8
Q

Occlusion of the _______ accounts for over 50%

A

LAD

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9
Q

Occlusion of the _______ accounts for 30-40%

A

RCA

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10
Q

Occlusion of the ____________ accounts for the remaining 10-20% of all cases.

A

Left Circumflex Artery

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11
Q

Distribution of Myocardial Infarcts (picture)

A
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12
Q

Occlusion of _______coronary artery is most common

A

LAD (over 50%)

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13
Q

Pathology of which disease?

  • The coronaries involved by atherosclerosis are transformed into rigid, heavily calcified cylinders
  • On cross-section- lumina are narrowed from the prominent fibrotic plaques and atheromas. The wall contains deposits of calcium salts and cholesterol clefts.
A

Coronary Artery Disease

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14
Q

What is an acute Myocardial infarction?

A

Rapid, sudden occlusion of a coronary artery

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15
Q

80-90% of transmural myocardial infarcts are caused by ____________.

A

thrombosis of a coronary artery

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16
Q

Other causes of ________=

ulceration of an embolized atherosclerotic plaque or prolonged vasospasm.

A

Causes of Acute MI

17
Q

Myocardial infarction:

What is the cause of Sudden Cardiac Death?

A

Most cases is from a major cardiac arrhythmia (i.e. V-fib) or later complete heart block and pump failure

18
Q

Myocardial infarction:

Sudden cardiac death occurs in approx. ___% of cases,

A

25%

–> the other 75% survivie

19
Q

What is this picture showing?

A

Opened LAD with Thrombosis and Acute Myocardial Infarct

20
Q

The following happens to who?

  • most develop signs of heart failure and cardiogenic shock.
  • multisystemic major organ failure develops (from lack of perfusion)
  • Cerebral ischemia (most dangerous)–> can lead to permanent mental injury/ loss of CNS function
A

What happens to the 75% of people who survive the onset of an MI

21
Q

Grossly, what are the 2 types of MI’s?

A

Morphologically, there are 2 types:

1. Transmural

  1. Subendocardial or intramural
22
Q

Which type of myocardial infarction involves all three layers of the heart, and usually involves the free wall of the left ventricle and/or the interventricular septum.

***This is more dangerous and can result in LV rupture

A

Transmural myocardial infarction

23
Q

Which type of myocardial infarction is usually concentric around the subendocardial layer of the left ventricle.

A

Subendocardial or Intramural Myocardial infarct