IHD & HHD

Question 1

What does hypertensive heart disease (HHD) refer to?

Answer 1

Heart-related problems that develop as a result of chronic high blood pressure.

Question 2

Approximately how many people are affected by hypertensive heart disease globally?

Answer 2

1.13 billion people.

Question 3

In which income countries is hypertensive heart disease more common?

Answer 3

Low/middle-income countries.

Question 4

List three risk factors for hypertensive heart disease.

Answer 4

• Smoking
• Diabetes
• Obesity
• Sedentary lifestyle
• Alcohol consumption

Question 5

True or False: Hypertensive heart disease is more common in women before the age of 60.

Answer 5

False.

Question 6

What is left ventricular hypertrophy (LVH)?

Answer 6

Thickening of the left ventricle to compensate for increased workload due to high blood pressure.

Question 7

What is diastolic dysfunction in the context of hypertensive heart disease?

Answer 7

Impairment of the heart’s ability to relax and fill with blood due to a stiffened thickened ventricle.

Question 8

What condition is accelerated by high blood pressure and leads to reduced blood flow to the heart?

Answer 8

Coronary artery disease.

Question 9

What is the essential feature of hypertensive heart disease?

Answer 9

Left ventricular hypertrophy.

Question 10

What can the heart weight exceed in hypertensive heart disease?

Answer 10

500 g.

Question 11

What is the normal left ventricular wall thickness?

Answer 11

1.2 to 1.4 cm.

Question 12

What is cor pulmonale?

Answer 12

Right ventricular hypertrophy and dilation caused by pulmonary hypertension.

Question 13

What are two possible onset types of cor pulmonale?

Answer 13

• Acute onset
• Slow and insidious onset

Question 14

What characterizes chronic cor pulmonale?

Answer 14

Right ventricular and often right atrial hypertrophy.

Question 15

What happens to the pulmonary arteries in pulmonary hypertension?

Answer 15

They undergo structural changes, including endothelial dysfunction and smooth muscle proliferation.

Question 16

What is ischemic heart disease (IHD) also known as?

Answer 16

Coronary artery disease (CAD) or coronary heart disease (CHD).

Question 17

What is the most common cause of ischemic heart disease?

Answer 17

Atherosclerosis.

Question 18

What happens during stable angina?

Answer 18

The heart muscle is temporarily deprived of oxygen during exertion or stress.

Question 19

What distinguishes unstable angina from stable angina?

Answer 19

Unstable angina occurs even at rest and indicates a higher risk of heart attack.

Question 20

What occurs during a myocardial infarction?

Answer 20

A coronary artery becomes completely blocked, usually due to a blood clot.

Question 21

What are the symptoms of a heart attack?

Answer 21

• Chest pain
• Shortness of breath
• Nausea
• Sweating
• Dizziness

Question 22

What does chronic ischemic heart disease lead to over time?

Answer 22

Heart failure.

Question 23

Where does the right coronary artery (RCA) originate?

Answer 23

From the right sinus of Valsalva.

Question 24

What does the left coronary artery (LCA) divide into?

Answer 24

• Left Anterior Descending (LAD) Artery
• Left Circumflex (LCx) Artery

Question 25

What are the patterns of myocardial infarction?

Answer 25

* Transmural Infarction * Subendocardial Infarction ## Footnote Subendocardial Infarction: * MIs limited to the inner third of the myocardium; these infarcts typically do not exhibit ST segment elevations * Is most vulnerable area to hypoperfusion and hypoxia

Question 26

What characterizes transmural infarction?

Answer 26

Involves the full thickness of the ventricle and is caused by epicardial vessel occlusion. ## Footnote These infarcts are also called ST-segment elevated MIs (STEMIs).

Question 27

What occurs in the first 0-24 hours after a myocardial infarction?

Answer 27

Coagulative necrosis, loss of nuclei, myocyte disarray, and no inflammation.

Question 28

What is the most common cause of death worldwide?

Answer 28

Ischemic heart disease (IHD).

Question 29

At what age is ischemic heart disease more common in men than women?

Answer 29

Over 50.

Question 30

What occurs in the 1-3 days after a myocardial infarction?

Answer 30

micro: early tissue breakdown, and initial granulation tissue at the borders ## Footnote gross: mottling w/ yellow-tan infarct center

Question 31

What occurs in the 3-7 days after a myocardial infarction?

Answer 31

Macrophage activity (phagocytosis of necrotic tissue), increased granulation tissue, and fibroblast proliferation ## Footnote gross: hyperemic border; central yellow-tan softening

Question 32

What occurs in the 1-2 weeks after a myocardial infarction?

Answer 32

Collagen deposition and scar formation with reduced inflammation ## Footnote gross: red-grey depressed infarct borders

Question 33

What occurs in the 1-2 months after a myocardial infarction?

Answer 33

Mature fibrous scar tissue with little vascularity or cellular activity ## Footnote gross: grey-white scar, progressive from border toward core of infarct; scarring complete