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Flashcards in Functional cardiac disorders Deck (73)
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1

what is CAD

atherosclerosis of coronary arteries- disease of the intima (inner lining)

2

what kind of disorder is CAD and how does it start

it is chronic and progressive
inflammation starts the process

3

what is the first stage of the CAD patho chain

inflammation-> endothelium damage-> lipids deposited-> lipids are oxidized and attract macrophages-> monocytes enter intima-> become macrophages which ingest LDL-> transformed into foam cells-> foam cells release cytokines-> cause inflammation and injury

4

what is the second stage of CAD patho

fatty streak starts causing narrowing

5

what is a fatty streak

yellow, lipid filled smooth muscle cell- an organized collection of foam cells

6

what is the third stage of CAD patho

fibrous plaque causes further narrowing

7

what is fibrous plaque

fatty streak + collagen + elastic fibers

8

what is the fourth stage of CAD patho

complicated (advanced) lesion hemorrhages causes clot formation and obstruction

9

what is complicated (advanced lesion

fibrous plaque (all the before things) hemorrhages

10

what is the incidence of CAD

#1 killer in us and other developed counteries

11

what are the 3 most dangerous risk factors for CAD

smoking
HTN
hyperlipidemia

12

what are the other risk factors for hyperlipidemia in CAD

age,
male gender under 60,
genetic predisposition (under 35),
hyper lipidemia

13

what causes hyperlipidemia in CAD

1. increase in dietary fat intake
2. diabetes and genetics
3. lipoproteins (lipids, phospholipids, cholesterol and triglycerides bound to carrier proteins

14

what are found in a blood lipid profile

total cholesterol
triglycerides
LDL
HDL

15

why does type 1 affect CAD

increased blood glucose accelerates CAD
2x men, 4x women

16

why does htn affect CAD

increased peripheral vascular resistances increases workload of heart and accelerates process of atherosclerosis

17

why does smoking affect CAD

1. nicotine- causes release of epi and increases hr and vasoconstriction
2. increased platelet adhesiveness- increases clot formation
3. CO- attaches to Hgb

18

women and CAD

women have a higher morality rate after acute MI
#1 killer of women all cancers together

19

how does cocaine and meth affect CAD

increases BP hr and causes vasoconstriction of coronary arteries

20

how does hyperhomocysteinemia affect CAD

causes injury to arterial walls
treat/prevent with folic acid (folate)

21

what is homocysteine

an amino acid from animal protein normally broken down in the liver with help of vitamin b6 b12 and folic acid.. increased amount CAD

22

how do we measure what is the role of inflammation in the development of CAD

c reactive protein-- high sensitivity-- increases measures inflammation

23

what is myocardial ischemia

local and temporary deficiency of blood supply due to obstruction of coronary circulation

24

how does CAD lead to angina

CAD-> myocardial ischemia after 10 seconds-> angina from lactic acid production during anaerobic respiration

25

what are the classical (transient) signs of myocardial ischemia

3-20 mins
pain- substernal pain, discomfort, heaviness, pressure, tightening, squeezing or aching
may radiate to neck, left arm, jaw, teeth, back

26

what are the non classical signs of myocardial ischemia

indigestion
upper back pain
jaw pain ONLY
increasing fatigue

27

what are the types of angina

stable
unstable

28

describe stable angina

predictable
similar events initiate attack (stress activity)
similar type of sensation with each attack
relief WITH REST and nitrates

29

describe acute coronary syndrome

sudden coronary artery obstruction due to thrombus formation over atherosclerotic plaque

30

what kind of angina is with acute coronary syndrome

unstable- unpredicable sensation often OCCURES WITH REST
indicates advanced CAD