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CV 7 IHD Flashcards

1
Q

ECG is a – method of evaluating the electrical activities of the heart

A

direct

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2
Q

standard ECG provides a –

A

60 sec recording

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3
Q

Abnormalities in cardiac cycle present as – in ECG

A

changes in length and amplitude of electrical waves

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4
Q

different leads provide different views of –

A

same electrical event

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5
Q

incidence of IHD

A

7 million people

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6
Q

incidence of MI

A

1.5 million people

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7
Q

myocardial oxygen demand in excess of supply

A

ischemia

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8
Q

continued ischemia leading to muscle damage

A

infarction

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9
Q

coronary arteries and capillaries usually have – resistance unless occluded

A

low

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10
Q

sense mechanical forces and regulates vascular tone

A

endothelium

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11
Q

protective cholesterol

A

HDL

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12
Q

best predictor of atherosclerotic heart disease

A

total cholesterol to HDL ratio (ideal is 3.5 and lower)

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13
Q

– has antifibrinolytic properties and an increase in – correlates with heart disease

A

lipoprotein

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14
Q

homocysteine (sulfur) excess has direct toxic effect on – interfering with clotting factors and promotion of LDL

A

endothelial cells

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15
Q

what can correct homocysteine excess?

A

folic acid

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16
Q

what is a marker of systemic inflammation?

A

C-reactive protein

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17
Q

Strongly correlated with risk of MI, stroke, peripheral arterial disease, and sudden cardiac death

A

C-reactive protein

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18
Q

what is emerging as an important risk factor

A

inflammation

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19
Q

Atheroma evolution: innate and adaptive inflammation in atherogenesis

A

foam cells release proinflammatory cytokines

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20
Q

Atheroma evolution: smooth muscle cells

A

migration and proliferation –> cell death

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21
Q

Atheroma evolution: arterial ECM

A

collagen deposits –> outward growth of intima

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22
Q

Atheroma evolution: angiogensis

A

plaque neovessels

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23
Q

chronic atherosclerosis

A

arterial stenosis, gradual occlusion and limited flow

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24
Q

acute atherosclerosis

A

disrupted plaque, rupture, and thrombosis

25
example of chronic disease
stable angina
26
example of acute disease
acute coronary syndrome
27
pain of cardiac ischemia
pressure, squeezing, burning
28
pain may radiate to --
left shoulder, jaw and arm (lower back for women)
29
no symptoms present, occurs commonly and mortality as high as with pain
silent ischemia
30
duration of stable angina
2-10 min
31
duration of unstable angina
< 20 min
32
duration of MI
> 30 min
33
nausea, vomit, cold sweat, SOB is associated with --
acute ischemia
34
heart sounds for cardiac ischemia
distant, gallop rhythms, occasional murmurs
35
cardiac ischemia's effect on lungs
rales
36
what is the most important element of diagnostic work up of acute vs chronic ischemia?
history
37
evidence of MI on EKG
abnormal ST and T wave
38
Limitations of EKG: when combined with -- for ischemia work up, sensitivity is only about 65% while specificity is 90%
exercise
39
when diagnosing an infarction --
changes in heart may take days to dev
40
myocardial perfusion diminishes with ischemia
nuclear cardiology
41
abnormal wall motion from ischemia or infarction
echocardiogram
42
demonstrates vessel obstruction
coronary angiography
43
most commonly used nuclear cardiology test
SPECT scan
44
SPECT scan: radioactive tracers are -- and images are obtained with heart at rest or after exercise
injected IV
45
because radioisotope concentration in myocardium depends on perfusion rate, SPECT scan shows --
ischemia
46
the-99
emits high photon (short 1/2 life)
47
tha-201
emits low photon (long 1/2 life)
48
shows presence of absence of perfusion and quantitative measurement of myocardial perfusion and metabolism
PET scan
49
PET scan uses isotope tracers tagged to a glucose analog and have very --
short 1/2 lives
50
what is the gold std
coronary angiography
51
blood tests are useful tests for --
infarction
52
useful screening for silent ischemia?
ambulatory EKG
53
angioplasty usually takes --
1 day
54
coronary artery bypass graft surgery or CABG takes --
a couple of days (open heart surgery)
55
ischemia can lead to --
contractile dysfunction arrhythmia infarction
56
blood test showing -- is a sign of infarction
cardiac troponin and creatine kinase MB isoenzyme
57
send balloon catheter to stretch coronary vessel
coronary angioplasty
58
do NOT use AB prophylaxis after 6 months of bypass surgery because --
stint may embolize --> another MI

Systems 1 (22 decks)

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